Massage and Gratuity: When You Should Tip Your Therapist (and How Much)

**This article is mostly based on my many years of experience working as an employee, independent contractor, and in private practice as a massage therapist. It is also based on my experience working as a therapist in southern California since 2011, so some things here may not apply to all regions of the US, so keep that mind. While also addressing the issue of gratuity and massage therapy, this article will also give you some deeper insight into the massage therapy industry today.

American tipping culture is unique compared to much of the world. Foreigners traveling to the US are often surprised how much more they're expected to pay for a service like massage or dining out. It has become commonplace to tip workers at fast food chains or coffee shops. Low wages, a lack of social safety nets, benefits, and labor unions, ever-rising inflation and living costs are major contributors to US tipping culture. The US federal minimum wage is still around $7 an hour! However, many states have legislation that forces businesses to increase this since nobody living in the US today could live off such a low and unreasonable wage.

Unfortunately, even with a wage increase to $15 to $21 an hour in many major US cities, it still leaves workers close to the extremely low-income or poverty demographic depending on the size of their household. For example, the area median income (AMI) in San Diego county, where I live, is around $130k a year. Rent for a single-bedroom apartment is usually $2k or more a month. Homes cost close to, or well above, $1 million! Families of 6 or less making under the AMI (below the $100k range) are considered low-income in San Diego, even a single person.

Massage therapists typically do not make anywhere near the AMI of San Diego county and generally fall into the low-income category, especially if they work for someone else. According to the U.S. Bureau of Labor Statistics, the median income of massage therapists in 2024 was about $50k a year which in many parts of California, puts those therapists in the very low to extremely low-income range.

For many massage therapists who often do not have a set annual salary, even $21 an hour can leave them close to or under the poverty line. Massage therapy, like many service industries, is often not financially consistent. In my experience as a therapist for 15 years, there are definite on-and-off seasons (even random on-and-off weeks or months that don't seem to have a clear pattern), which means that certain months are more challenging than others for paying bills, buying food, and making rent (not to mention putting aside money for savings, retirement, or income taxes, something I struggled to do for many years as a contracted or employed therapist).

A common question massage clients have is whether they should tip their therapist and, if so, how much is reasonable. Massage services today can sometimes cost between $100-$150 (or more) for an hour-long massage, especially at higher-end spas, resorts, or luxury hotels. However, even Massage Envy in most Southern California regions falls into this higher range. Paying extra to tip your therapist can make a massage service expensive, something that a lot of Americans consider a rare luxury experience.

In most situations, your therapist isn't making much money from each service, even if they're working at a high-end luxury spa or resort. To fully answer this question, you should first consider whether or not your therapist works as an employee, independent contractor, or is entirely self-employed in their own business. Knowing and identifying these different categories is important because your therapist could be making only a quarter of the service cost (or less).

Depending on where they live and what category they fall into, your therapist will likely benefit a lot from receiving tips, especially for a service that demands a lot from them. Your therapist is performing a very physically demanding job, and to make a living, they often have to take on a high client load, sometimes performing up to five or six sessions a day.

Massage therapy is hard work often not well compensated for, especially considering all that’s involved in starting out or becoming proficient. Massage therapists require specialized school and training that can cost thousands, and they also have to pass exams and stay current with licenses or certifications (depending on the state they work in). With insurance included, therapists are required to pay hundreds extra a year to be eligible to work.

Employed Massage Therapists

Most likely, if you are receiving a massage service in a hotel, resort, spa, or massage franchise chain (like Massage Envy), your therapist is very likely to be an employee, in which case they are making anywhere from $18-$40 an hour (sometimes less!), usually somewhere in the middle for those starting in those companies. They sometimes make commissions on products and service upgrades. In this situation, tipping your therapist is encouraged. A tip of $20-$40 is common, or somewhere around 20% of the service price. Employed therapists have set hours and have to clock in for shifts, though they don't always have guaranteed full days.

Therapists working as employees only receive higher pay for booked services and commissions. Often, when they have slower days, they will only earn minimum wage for hours not booked (when they're considered "on-call" waiting for walk-ins or same-day appointments), so even if working a full day, their hourly income will vary considerably for that day. If the day is extremely slow, employed therapists are often sent home with fewer hours. That way, businesses can avoid paying them minimum wage for time not booked. Tips help make up for this.

Independent Contractors

Suppose your therapist works in a clinical setting, like a chiropractic office or acupuncture clinic. In that case, they are often working as a contractor (though sometimes they can be employees or even work in private practice). The pay rate for a contractor is similar to an employee, depending on their experience and how much the rates are for services (since they are making a percentage of that rate). For contracted therapists working in a physical location, the business they work for will often take care of marketing, supplies, equipment, rent, manage the booking and transactions (and provide the space), so the percentage is usually close to a 50/50 split. Over the past decade, I have made somewhere between $28-$47 an hour working in such settings.

Generally, it is recommended to tip your therapist in these settings since they also do not receive employee benefits (like healthcare, retirement packages, or paid sick leave or vacation). Additionally, they get hit with high self-employment income tax (something they have to set money aside every month or pay quarterly, which is challenging during slower months).

Similar to therapists who are employed, a tip of $20-$40 is common, or again, somewhere in the range of 20% of the service price. Also, consider that unlike employees, therapists who work as contractors are not often paid for hours they aren't booked. This means that on slower days, and especially days with schedule gaps, they can wait around completely unpaid, sometimes for several hours between appointments.

By the way, it is insulting to not show up for an appointment booked especially at settings that have contracted therapists, since your therapist may have come in just for that appointment only to be turned away. This is quite common, something I endured for years working in an acupuncture clinic where new clients would book online, usually the day before, and then never show up. Even if the business charges a short-notice cancellation fee that they give to the therapist, this never compensates for the lost time and money, especially if they could have worked elsewhere. Getting up, ready, and showing up on time for a service you won’t end up performing (or being paid for) is frustrating.

Many therapists who work as contractors usually have other jobs (even employed massage therapists typically do since getting full-time positions takes time). Working primarily as a contractor is ideal for therapists who need schedule flexibility (where they can set their own hours) to work around other jobs, school, or private client work. Usually, therapists who choose these situations (despite the disadvantages) are working to build a private client base so they can eventually shift to a self-employed practice.

Contractors also include therapists who work for mobile/in-home massage businesses like Zeel. These therapists usually work for these companies on the side and also have other jobs, so while they will generally make more money per session as contractors for mobile companies, they aren't likely to do that kind of work full-time. Plus, such therapists are driving to your home, office, or hotel to set-up and perform a service, so gratuity is even more appropriate. However, some companies factor gratuity into the service cost, so check with the company when booking to inquire about that.

Fully Self-Employed Business Owners

Therapists working in clinical settings sometimes rent out space, so they can fall into this latter situation of being entirely self-employed in their own business. In this case, even if they pay rent, they are earning the full price of their services (minus taxes, of course). Typically, a therapist running their own practice and renting space in a clinical setting will more likely take care of their own scheduling and transactions rather than the facility they rent from. A therapist renting out space in a chiropractic or acupuncture clinic, working out of an office or home studio, or doing independent mobile/in-home massage, is usually in a much better position financially and is well compensated for their work.

In my private practice work (both at my home studio and with mobile/in-home massage services), I will tell my clients that tips are appreciated but not necessary since I am well-compensated by my set rates. This is a main benefit of being entirely self-employed as a therapist. You can often double or sometimes triple your income, and with a busy and consistent client base, you can make a decent living. You can also lower your fees for more consistent clients with packages and memberships to make your services more affordable.

However, building a business is hard, and finding a place to build a clientele can be very challenging. Office spaces, especially in major cities, are expensive (and involve long-term leases that can be risky if you're starting out). Not everyone has the space or ideal home office or studio location. Healthcare and other benefits from employers can be challenging to give up, especially for those with families or chronic health issues.

Also, marketing and entrepreneurship are a whole skillset and job in themselves, and many therapists aren't wired for it or do not have the time and energy for the hustle it often requires, especially in the beginning stages of starting a private practice. These barriers often prevent many therapists from branching off on their own and tipping your therapist who is employed or works as a contractor helps them a lot.

Final Thoughts

If you're unsure of your therapist's situation, you can always ask them, and even ask if they appreciate and depend on tips. Also, if a $20-40 tip is too much for you, anything is appreciated. I have worked at a lower-cost community acupuncture clinic for a decade because I enjoy helping everyday hard-working people. I gave up a job at a high-end spa and resort with a highly wealthy clientele (we're talking billionaires!) to work in a more humble and relatable environment.

I enjoy my work because I love making a positive impact in my community, especially for those who rely on massage to manage injuries, chronic pain, or high stress. I also value having a job that doesn't compromise my values or integrity. However, not all of my clients over the years have been able to afford to tip me higher tips in my contract jobs, so $10 to $15 is also common.

I have appreciated any extra amount I have recieved. Also, consider that tipping, in its ideal, is to reward for a service that was done well or that went above and beyond what was expected. Consider how much the service provider put into your treatment or service and how much you'd be willing to reward them for that. Lastly, consider whether you have the means to pay a bit extra for your service. If not, that's okay. Tip what you can.