CAMLAW: Complementary and Alternative Medicine Law Blog

Massage Therapy Licensure and Regulations

Massage therapy licensing requirements vary by state (some states regulate by town ordinance), although once again the Department of Labor website has some helpful information about massage therapy licensure rules.

According ot the DOL:

"Training standards and requirements for massage therapists vary greatly by State and locality. In 2004, 33 States and the District of Columbia had passed laws regulating massage therapy in some way. Most of the boards governing massage therapy in these States require practicing massage therapists to complete a formal education program and pass the national certification examination or a State exam. Some State regulations require that therapists keep up on their knowledge and technique through continuing education. It is best to check information on licensing, certification, and accreditation on a State-by-State basis.

"There are roughly 1,300 massage therapy postsecondary schools, college programs, and training programs throughout the country. Massage therapy programs generally cover subjects such as anatomy; physiology, the study of organs and tissues; kinesiology, the study of motion and body mechanics; business; ethics; as well as hands-on practice of massage techniques. Most formal training programs require an application and some require an in-person interview. Training programs may concentrate on certain modalities of massage. Several programs also provide alumni services such as post-graduate job placement and continuing educational services. Both full- and part-time programs are available.

"These programs vary in accreditation. Massage therapy training programs are generally accredited by a State board or other accrediting agency. Of the many massage therapy programs in the country, about 300 are accredited by a State board or department of education-certified accrediting agency. In States that regulate massage therapy, graduation from an approved school or training program is usually required in order to practice massage therapy.

"After completion of a training program, many massage therapists opt to take the national certification examination for therapeutic massage and bodywork. This exam is administered by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB), which has eligibility requirements of its own. Several States require that a massage therapist pass this test in order to practice massage therapy. In States that require massage therapy program accreditation, an exam candidate must graduate from a State-licensed training institute with at least 500 hours of training or submit a portfolio of training experience for NCBTMB review; in locations that do not require accredited training programs, this is unnecessary. After the applicant is approved for testing, the applicant may schedule a test time at a local testing center. Tests are available six or seven days a week, depending on the test site, and are entirely computer based with multiple choice questions. The exam covers six areas of content: general knowledge of the body systems; detailed knowledge of anatomy, physiology and kinesiology; pathology; therapeutic massage assessment; therapeutic massage application; and professional standards, ethics, business and legal practices.

"When a therapist passes the national certification exam for therapeutic massage and bodywork, he or she can use the recognized national credential: Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). The credential must be renewed every four years. In order to remain certified, a therapist must perform at least 200 hours of therapeutic massage during the four year period, and complete a minimum of 48 credit hours of continuing education. In 2005, the NCBTMB introduced a new national certification test and corresponding professional credential. These are the national certification exam for therapeutic massage and the Nationally Certified in Therapeutic Massage (NCTM) credential. The new test covers the same topics as the traditional national certification exam, but covers fewer modalities of massage therapy. Recognition of this new national certification varies by State.

"Many of the national, State, and local requirements coincide. States that require the national credential also require accredited training programs to comply with NCBTMB standards of training. Professional associations require that a professional member graduate from a training program that meets NCBTMB standards, have a State license, and/or have a national certification from the NCBTMB. Actual requirements differ on a State-by-State basis.

"Because of the nature of massage therapy, opportunities for advancement are limited. However, with increased experience and an expanding client base, there are opportunities for therapists to increase client fees, and therefore income. Both strong communication skills and a friendly, empathetic personality are extremely helpful qualities for fostering a trusting relationship with clients and in turn, expanding one's client base. In addition, those who are well organized and have an entrepreneurial spirit may even go into business for themselves. Self-employed massage therapists with a large client base have the highest earnings."

This is all a great update to resources on licensing and credentialing complementary and alternative medicine providers, including Eisenberg DM, Cohen MH, Hrbek A, Grayzel J, van Rompay MI, Cooper, RA. Credentialing complementary and alternative medical providers. Ann Intern Med; 2002;137:965-973.

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Michael H. Cohen, Esq.; 468 North Camden Dr. | Beverly Hills, California 90210 | 310-844-3173