Massage Therapist Licensing

Most states require training and licensing for massage therapists.

Licensure for massage therapists (MTs) varies by state, but typically requires (ABMP 2023):

• Completing 500-700 hours of vocational training (47 states).
• Passing a national exam administered by the Federation of State Massage Therapy Boards (45 states).
• Obtaining a U.S. license by the National Certification Board for Therapeutic Massage and Bodywork (45 states).
• Confirming national credentials through state massage therapy board registration (47 states) and licensure (45 states).

In 45 states, licensed MTs who operate as ‘brick and mortar’ businesses must also register with state MT boards and/or Depts. of Revenue.

CA and VT require 500 hours of training and registration with the state board only. In MN, KS, and WY, MTs are unlicensed at the state-level.

Missouri

MTs are required to have 500 hours of training, pass the national exam, obtain a national license, register with the Missouri State Board of Therapeutic Massage, and attend 12 hours of training (CEUs) every 2 years (AMTA n.d.; RSMo 324.265)

• In 2021, there were roughly 6,600 licensed MTs in MO, with 1,200 MTs practicing (BLS 2021; DCI 2023).
• In 2021, less than 1% of license holders (or 30-35 cases) received disciplinary actions against their license (DCI 2023).

The MO Board of Therapeutic Massage receives about 1,000 new applications for state licenses annually. Their other regulatory activities include inspecting facilities, investigating complaints or unlicensed activities, and reviewing curriculum.

For more on vocational careers, please read the Science Note, Vocational Training in Missouri.

Licensure can prevent illicit activities.

In interviews, MTs report that licensure provides a safe and professional framework for performing their duties, which can be unclear (e.g., what constitutes massage), vague (e.g., parameters of excellence), or done without collaboration from medical professionals (Sherman 2005).

• MTs, 86% of whom are female, can feel isolated or threatened by sexual harassment, particularly in unlicensed settings (Fortune 2010; AMTA 2021).

Unlicensed massage businesses can run in buildings that require minimal business licensing and evade inspection by MT boards (National Human Trafficking Hotline n.d.).

• In 2015, roughly 3,000 cases of human trafficking and illegal prostitution related to massage parlors were reported in the U.S. (SC Dept. of Labor 2018).
• Up to 9,000 unlicensed massage businesses exist in the U.S. In 2012, roughly 7,000 unlicensed massage parlors were illegal prostitution sites (FSMTB 2017).

Disciplinary actions against massage therapists vary by state.

Formal complaints against MTs are usually filed with the state board who issued the license. Individual state laws or board standards dictate when a MT’s license can be revoked. The usual process involves:

1) A formal complaint made to licensing board.

2) An investigation into the claims, including witness testimony, records inspection, and written response to questions.

3a) A consent order, or formal admission of guilt is sent OR

3b) A hearing by a judge or board where the license holder can defend against the accusations (with attorney if allowed).

4) A final action where necessary discipline (up to and including license revocation) occurs.

Common offenses for license removal include illegal sexual contact with clients, sanitation violations, fraudulent activities, performing pro-cedures outside of scope, criminal convictions, substance use, and unlicensed MTs on duty.

• Disciplinary actions prior to license removal can include fines, formal reprimands, mandatory counseling, probation, restric-tions, or temporary suspensions (Professional License Defense, LLC, n.d.).

Interim or Emergency License Suspensions

When a formal complaint is filed against a licensed MT, the MT board or a judge may issue an immediate order to suspend an MT license while health departments or boards investigate the malpractice claim(s) (Professional License Defense, LLC, n.d.).

• In MO, a complaint filed with the MT Board can be forwarded to the Administrative Hearing Commission for temporary suspen-sion while the board investigates. No time-line is provided for when hearings are required (RSMo 324.262).

Neighboring State Policies

The IL Secretary of the Dept. of Healthcare and Family Services oversees suspension hearings.

• Licenses may be suspended without a hearing if there is evidence of risk to consumers by allowing the MT to continue practice (225 ILCS 57/1).

In AR, the Abstractors’ Board and the MT Technical Advisory Committee hold hearings to suspend or revoke licenses based on if complaints against the MT are valid (AR State Board of Health 2019).

KY does not have a temporary suspension process. MTs who are alleged of a complaint have 20 days to respond in writing to the Board of Licensure for MT.

• Formal hearings and subsequent investiga-tions (conducted by a board member) are determined at monthly meetings (KY BLMT 2016).

References

Adopted Rules For Massage Therapy in Arkansas REVISED: August 2019. (2019). Arkansas State Board Of Health. Retrieved from https://www.arkleg.state.ar.us/Calendars/Attachment?committee=040&agenda=3557&file=D.11.b+ADH+Rules+for+Massage+Therapy+in+Arkansas+and+Relevant+Acts.pdf 

Brown, T. N. (2018). Illicit Massage Businesses. South Carolina Department of Labor, Licensing and Regulation. Retrieved from https://dc.statelibrary.sc.gov/bitstream/handle/10827/48510/ADM_CPM_Brown_Illicit_Massage_Businesses_2018-02-01.pdf?sequence=1 

Fake Massage Businesses. National Human Trafficking Hotline. Retrieved from https://humantraffickinghotline.org/en/sex-trafficking-venuesindustries/fake-massage-businesses 

FAQ for Massage Therapists. Professional License Defense, LLC. Retrieved from https://www.professionallicensedefensellc.com/faq-for-massage-therapists 

Fiscal Year 2023 Budget Request. (2023). Missouri Department of Commerce and Insurance. Retrieved from https://oa.mo.gov/sites/default/files/FY_2023_Commerce_and_Insurance_Budget_Request.pdf 

Fortune, L. D., & Gillespie, E. (2010). The influence of practice standards on massage therapists’ work experience: a phenomenological pilot study. International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice, 3(3), 5-11.  

Human Trafficking Task Force Report. (2017). Federation Of State Massage Therapy Boards. Retrieved from https://www.fsmtb.org/media/1606/httf-report-final-web.pdf 

Interim Suspension Order. Professional License Defense, LLC. Retrieved from https://www.professionallicensedefensellc.com/interim-suspension-order 

Laws And Regulations Relating To Licensure As A Massage Therapist. (2016). Kentucky Board of Licensure for Massage Therapy. Retrieved from https://adc.ky.gov/Documents/Laws%20and%20Regulations%20Booklet.pdf 

Massage Therapy Industry Fact Sheet. (2021). American Massage Therapy Association. Retrieved from https://www.amtamassage.org/publications/massage-industry-fact-sheet/ 

Massage Therapy State Licensing Requirements. (2023). Associated Bodywork & Massage Professionals Retrieved. from https://www.abmp.com/practitioners/state-requirements 

Occupational Employment and Wages, May 2021 - Massage Therapists. (2021). U.S. Bureau of Labor and Statistics. Retrieved from https://www.bls.gov/oes/current/oes319011.htm 

Professions, Occupations, And Business Operations (225 ILCS 57/) Massage Licensing Act. (2022). Illinois General Assembly. Retrieved from https://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=2469&ChapterID=24 

Sherman, K. J., Cherkin, D. C., Kahn, J., Erro, J., Hrbek, A., Deyo, R. A., & Eisenberg, D. M. (2005). A survey of training and practice patterns of massage therapists in two US states. BMC Complementary and Alternative Medicine, 5, 13. doi:10.1186/1472-6882-5-13 

State Regulations. American Massage Therapy Association. Retrieved from https://www.amtamassage.org/state-regulations/