Massage Therapy

Massage therapy means the manipulation of soft tissue by hand or through a mechanical or electrical apparatus for the purpose of body massage. The term includes effleurage (stroking), petrissage (kneading), tapotement (percussion), compression, vibration, friction, nerve strokes, and Swedish gymnastics. Massage therapy may include the use of oil, lubricant, salt glows, heat lamps, hot and cold packs, or tub, shower, jacuzzi, sauna, steam or cabinet baths. Massage therapy is a health care service when the massage is for therapeutic purposes, and a licensed massage therapist may receive referrals from a physician to administer massage therapy.


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News and Updates

86th Legislative Session Update

Revised Guidelines for Massage Therapy

In conjunction with Gov. Greg Abbott’s July 2nd Executive Order (GA-29), the Governor’s Strike Force to Open Texas has revised the guidelines for certain businesses.

Effective immediately, all employees and customers must wear a face covering (over the nose and mouth) while inside a massage establishment. Face masks or fabric face coverings must be worn at all times by employers, employees, contractors, and clients while inside the establishment, even if individuals are practicing social distancing. Face coverings can be removed temporarily only when necessary to receive a service. 

Please note that all massage therapy licensees should follow these health guidelines:

Massage Therapy Establishment Operators

The Strike Force to Open Texas also released guideline for customers to use when visiting a barber shop:

Massage Therapy Establishment Customers

86th Legislative Session Update

Notice to Health Care Practitioners of New Training Requirement

House Bill 2059 requires certain health care practitioners to complete a Health and Human Services Commission (HHSC) approved human trafficking prevention training course to renew their license. The bill also requires HHSC to post a list of approved courses on their website. Licensees are required to comply with the training requirements beginning September 1, 2020. For more information, visit our Human Trafficking Prevention Training for Health Care Practitioners webpage.

Clarification on Temporary Distance Education

The Governor’s Executive Order dated May 5, 2020, allowed Barber and Cosmetology schools and Massage schools to reopen on May 18, 2020. The Texas Department of Licensing and Regulation (TDLR) understands there are still concerns as plans are made to open Texas while minimizing the spread of COVID-19, including temporary restrictions to ensure continued social distancing as our communities resume normal activities in a safe manner.

Due to these concerns, schools can continue to utilize temporary distance learning and virtual learning to complete all technical standards for the theory and practical portion of a course. This allows schools to determine when they can safely transition students back into their traditional brick and mortar classrooms. TDLR’s goal is to enable schools to continue to teach their students despite the current circumstances related to COVID-19.

TDLR’s temporary provisions are in line with the U.S. Department of Education and provide flexibility to schools to help students complete their course work while effectively developing the job skills and knowledge to obtain a license in Texas. However, remote practical instruction does not include internship or apprenticeship instructional hours.

Schools engaging in the delivery of distance education with remote instruction must ensure that all hours are properly accounted for each student engaged in the remote theory and practical hours of instruction, including record of attendance and time clock records. Additionally, schools must ensure the identity of the distance-learning student, the student/instructor ratio limitation, and the student’s ability to be equipped with the proper tools to effectively demonstrate the practical applications. Schools must maintain compliance with all statutory requirements.

Schools should notify TDLR when the school resumes all regular, traditional on-campus classes or activities and ceases temporary distance education. Notice should be provided by email at Education@tdlr.texas.gov

These provisions will remain in place until further notice.

Updates to Governor's Executive Order: Massage Establishments and Laser Hair Removal Establishments May Reopen Immediately Except in Deaf Smith, El Paso, Moore, Potter, and Randall Counties

Under the Executive Order GA-23 issued by Gov. Greg Abbott on May 18, laser hair removal establishments, massage therapy establishments, massage schools, and other places where massage therapists may practice their trade may reopen immediately, except in Deaf Smith, El Paso, Moore, Potter, and Randall counties. (These activities may resume in those counties on May 29.)

Re-opened laser hair removal establishments and places offering massage therapy must ensure at least six feet of social distancing between operating workstations. Please note that all massage therapists and laser hair removal technicians should follow these health guidelines (PDF).

Consumers should consult this document (PDF) for info.

Services
Customers

Further Clarification of Massage Therapy Services Allowed

Under the Governor’s Executive Order GA-21 (GA-21), massage establishments must remain closed until further notice. GA-21 also prohibits people from providing services which are not designated as essential or re-opened, including massage therapy.

GA-21 designates healthcare providers, including physicians and chiropractors, as essential. It does not include massage therapists, unless they are providing services determined to be medically necessary by a physician, chiropractor, or other healthcare provider. Massage therapy that is not medically necessary is still not allowed. If a licensed massage therapist performs a medically necessary massage, they must do so in accordance with the massage therapy laws and rules, including the requirement of a consultation document. A medically necessary massage may be performed in the office of a physician or chiropractor or any other place that is exempt from the requirement for a massage establishment license under Texas Occupations Code §455.155.

Please note that GA-21 overrides conflicting local orders, and the ability to provide massage therapy may change as further orders are issued.

Attorney General Issues Guidance Re: Barbershop, Cosmetology Salon, Nail Salon, Esthetician Salon, Massage Establishment and Laser Hair Establishments Closures

Yesterday, the Texas Attorney General's Office released a guidance letter to address questions relating to Governor Abbott's Executive Order GA-18. Barbershops, cosmetology salons (including nail and esthetician), massage establishments, and laser hair establishments must remain closed until further notice. The Governor's order overrides conflicting local and county orders.

Cosmetology Salons, Nail Salons, Estheticians, Mini-Salons, Barber Shops, Laser Hair Removal Establishments and Massage Therapy Establishments Remain Closed

Under Executive Order GA-18 issued by Gov. Greg Abbott on April 27, all cosmetology salons (including nail salons, estheticians, and mini-salons), barber shops, laser hair removal establishments and massage establishments shall continue to remain closed. Executive Order GA-18 overrides all local and county orders.

Whether a salon or shop is a sole proprietorship or not, they are to remain closed until Executive Order GA-18 is amended or rescinded.

Thank you for continuing to do your part to keep Texas safe by remaining closed. To read more about the Governor's plan to reopen Texas, please go to https://gov.texas.gov/uploads/files/organization/opentexas/OpenTexas-Report.pdf.

Updates to Massage Therapy Law(s)

House Bill 1865 passed by the 86th Texas Legislature, amended Occupations Code, Chapter 455, relating to the licensing and regulation of massage therapy; requiring a student permit; authorizing fees. House Bill 1865 and the changes to Chapter 455 became effective September 1, 2019, except Section 455.2035 that takes effect July 1, 2020.

House Bill 2747 also passed by the 86th Texas Legislature, amended Occupations Code, Chapter 455, relating to the licensing and regulation of massage therapy. House Bill 2747 and the changes to Chapter 455 became effective September 1, 2019. TDLR encourages all persons interested in the Massage Therapy program to review the updated Occupations Code, Chapter 455.

Clarification of Massage Therapy Services Allowed

A massage therapist may only provide massage services if it is medically necessary. This determination must be made by the client's physician or chiropractor. Massage therapists may not provide massage services for general wellness or other non-medical necessity reasons.

This guidance is in accordance with Executive Orders GA-15 and GA-16 recently issued by Governor Abbott. Massage therapists should be aware of any orders issued in the county or city where the massage therapist practices, as these local orders may impose additional restrictions. The ability to provide massage therapy may change as further governmental orders are issued.

TDLR Health Monitor – April 2020 Edition

Articles in this April 2020 edition of The Health Monitor include updates on:

  • TDLR’s response to COVID-19
  • TDLR represented at State Operations Center
  • Scam targeting DEA registrants and health professionals
  • New human trafficking prevention training required for certain health care practitioners
  • Massage Therapy rule amendments adopted
  • Penalty matrices adopted for Behavior Analysts and Dyslexia Therapy programs
  • Surprise medical billing updates
  • Verify your license online

The TDLR Health Monitor is a quarterly newsletter that provides news and information about TDLR’s medical and health-related programs. Archives of past editions of the TDLR Health Monitor can be viewed here.

Governor's Order Re-Opening Retail Businesses

The Governor's Executive Order today focuses on retail businesses. It continues the closure of cosmetology salons, barber shops or massage establishments for services. Starting April 24, those businesses may sell products via pickup, delivery by mail or delivery to the customers’ doorstep in strict compliance with the terms required by the Texas Department of State Health Services, which can be found at www.dshs.texas.gov/coronavirus. Gov. Abbott stated today that the next step in the re-opening process for Texas will be announced April 27. Please continue to go to our COVID-19 page for updates, and sign up for our email updates as well.

Notice to Educational Providers

RE: Provisions to allow Massage Therapy schools to offer practical instructions remotely.

The health and safety of all our licensees is of the utmost importance. To proactively address the concerns regarding COVID-19, the Texas Department of Licensing and Regulation (TDLR) will allow Massage Therapy schools to use technologies such as videos of hands on work, electronic learning, virtual learning, and other practices that would effectively deliver the practical portion of the school’s curriculum to ensure that a student develops the job skills and knowledge to obtain a license in Texas.

Schools must ensure that all hours are properly accounted for each student engaged in remote practical applications, in accordance with Chapter 117 and Section 117.64, including a record of attendance and time clock record. Additionally, schools must ensure the identity of the distance learning student, the student/instructor ratio limitation, and the student’s ability to be equipped with the proper tools to effectively demonstrate the practical applications.

Remote practical instruction does not include internship or apprenticeship instructional hours. TDLR’s goal is to enable schools to continue to teach their students despite the current circumstances related to COVID-19.

Licensed Schools that may be impacted by COVID-19 can notify TDLR by email at education@tdlr.texas.gov with the subject line of the email as “COVID-19 remote practical instruction” and provide the following information:

  • School name and license number;
  • Type of delivery method, including the platform, technology, or program being used for distance education;
  • Verification that the school will maintain photo or video evidence to confirm the practical work attendance; and
  • Type of method which will be used for tracking student attendance, including hours completed.

These provisions will remain in place until further notice.

COVID-19: Continuing Education Waived

TDLR continuing education requirements are waived for all individual licenses expiring in March, April, and May 2020. Licensees still need to submit their renewal applications, pay the required fees, and TDLR will check their criminal histories, but they will not need to complete any TDLR-required continuing education this licensing cycle. (§51.405, Occupations Code)

Note: TDLR is not authorized to waive continuing education requirements imposed by a certifying or credentialing entity other than TDLR. If a certifying entity requires continuing education to maintain certification, and certification is required for Texas licensure, then that continuing education must be completed. If the certifying entity waives continuing education or allows it to be completed on a delayed basis due to COVID-19, then you may follow the certifying entity’s policy.

Please check the TDLR COVID-19 webpage for the most up-to-date information.

Texas Massage Establishments Closed From March 20 to April 3

As of midnight on March 20, all Texas massage establishments are closed until April 3 by executive order of Gov. Greg Abbott. The closure is intended to help slow the spread of the COVID-19 pandemic.

Important Notice Regarding MBLEX

Effective immediately, Pearson VUE, the provider of the MBLEx for the massage therapy program has closed testing centers in the United States and Canada. To learn more, view the Federation of State Massage Therapy Boards Statement or visit the Person Vue webpage.

Provisions for Temporary Emergency Distance Education at Barber, Cosmetology, Driver Education and Massage Schools

The health and safety of all our licensees is of the utmost importance. To proactively address the concerns regarding COVID-19, the Texas Department of Licensing and Regulation (TDLR) has enacted temporary emergency distance education provisions to allow current licensed schools to offer distance education limited to the theory hours of instruction to not exceed more than 50 percent of the course. TDLR’s temporary emergency provision is in line with the Department of Education to provide flexibilities for schools to help students complete their course work.

Courses taught by distance education will not satisfy requirements of practical (hands-on) portions of course curriculum. The goal of the department is to enable schools to continue to teach their students despite the current outbreak of COVID-19.

Licensed Schools that may be impacted by COVID-19 can notify the department by email TDLR at education@tdlr.texas.gov with the subject line of the email as “COVID-19 Temporary Emergency Distance Education Request” and provide the following information:

  • School name and license number
  • Type of delivery method, including the technology or program being used for distance education
  • Type of method which will be used for tracking student attendance, including hours completed
  • Timed outline indicating the portion of the course or curriculum which will be completed by distance education

Temporary emergency distance education accommodations will remain in place until further notice.

Ray Pizarro
Education and Examination Director

TDLR Adopts Amendments, New Rules, and Repeals to Administrative Rules

The Texas Commission of Licensing and Regulation (Commission) adopted amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 117, Subchapter A, §117.2; Subchapter C, §§117.20, 117.21, and 117.23; Subchapter D, §117.31; Subchapter E, §117.40; Subchapter F, §§117.50 - 117.55, 117.57 - 117.59, 117.61, 117.62, 117.64, and 117.65 - 117.68; Subchapter G, §§117.80, 117.82, and 117.83; Subchapter H, §§117.90, 117.91, and 117.93; Subchapter I, §117.100; new rule Subchapter C, §117.25; and the repeal of Subchapter F, §117.56 and §117.60, regarding the Massage Therapy Program. The adopted amendments implement House Bill (HB) 1865 and HB 2747, 86th Legislature, Regular Session (2019), and include recommendations from the Massage Therapy Advisory Board Standard of Care workgroup and Education and Examination workgroup.

The adoption justification was published in the January 24, 2020 issue of the Texas Register (45 TexReg 543). The updated rule chapter will be made available upon its effective date of February 1, 2020.

Guidance Statement on TDI Rules Related to Senate Bill 1264

The Texas Department of Insurance (TDI) has adopted emergency rules interpreting Senate Bill (SB) 1264’s prohibitions related to “surprise billing” (or “balance billing”). This Guidance Statement is intended to provide clear information concerning SB 1264 to Texas patients, clients, and health care providers under the regulatory authority of the Texas Department of Licensing and Regulation (TDLR).

SB 1264 prohibits surprise billing, with certain exceptions. Health care providers under TDLR’s regulatory authority who seek to exercise the exceptions to SB 1264’s prohibitions against balance billing must comply with all provisions of SB 1264, including as interpreted by TDI rules. See the TDI SB 1264 webpage for additional information. SB 1264 applies to a health care or medical service or supply provided on or after January 1, 2020.

TDLR will be responsible for investigating complaints and taking disciplinary action against TDLR licensees for violations of SB 1264, including as interpreted by TDI rules. Any person who believes that a TDLR-licensed health care provider has committed a balance billing-related violation may file a complaint online with TDLR. Additionally, TDLR and TDI will work together to ensure that any complaints filed with TDI regarding TDLR licensees will be referred to TDLR and investigated.

TDLR will be working on the development of enforcement rules consistent with SB 1264 and TDI’s rules interpreting the statute. As rulemaking moves ahead, we look forward to a transparent process and engaging the public and stakeholders on this important issue.

Online Renewal for Massage Therapists and Instructors

Starting September 9, 2019, TDLR massage therapist or massage therapy instructors can sign up for a Texas.gov account for license renewal. Once linked to an account, the new Texbadge service is a fast, easy, and fully mobile-optimized way to renew.

New Fingerprint Requirements

As of September 1, 2019, people who are applying for an initial massage therapist, massage instructor or massage establishment license or who are renewing their massage therapist, massage instructor or massage establishment license must submit fingerprints that will be used to obtain the applicant’s criminal conviction history. Under House Bill 1865 (86th Texas Legislature), all licensees must comply with the fingerprint requirement no later than September 1, 2021.

TDLR Adopts Revised Enforcement Plan

The Texas Commission of Licensing and Regulation (Commission) provides this public notice that at their regularly scheduled meeting held July 15, 2019, the Commission adopted the Texas Department of Licensing and Regulation’s (Department) revised enforcement plan which was established in compliance with Texas Occupations Code, §51.302(c).

The enforcement plan gives all license holders notice of the specific ranges of penalties and license sanctions that apply to specific alleged violations of the statutes and rules enforced by the Department. The enforcement plan also presents the criteria that are considered by the Department’s Enforcement staff in determining the amount of a proposed administrative penalty or the magnitude of a proposed sanction. The enforcement plan is revised to include the penalty matrix for the Massage Therapy program.

The Texas Legislature enacted Senate Bill 202 (S.B. 202), 84th Legislature, Regular Session (2015), which transferred regulatory authority of 13 programs, to include Massage Therapy from the Texas Department of State Health Services to the Commission and Department. The Massage Therapy penalty matrix provides for a single range of penalties for each class to eliminate confusion and allow the industry to fully understand the penalties assessed. The penalty matrix describes the specific ranges of penalties and license sanctions that apply to specific violations of the statutes and rules enforced by the Department. This penalty matrix may differ slightly from others as the agency focuses on aligning strategic plan goals with agency resources.

The Massage Therapy Advisory Board recommended approval of the penalty matrix at their meeting held June 11, 2019.  The penalty matrix was presented to the Commission on July 15, 2019 and was adopted as recommended.

Conviction Guidelines for Massage Therapy Program

The Texas Commission of Licensing and Regulation (Commission) adopted changes to TDLR’s Conviction Guidelines (guidelines) to include the Massage Therapy program.

The guidelines describe how TDLR determines whether a criminal conviction makes an applicant unsuitable for a license, or whether a conviction warrants revocation or suspension of a license previously granted. The guidelines present the general factors that are considered in all cases and the reasons why particular crimes are considered to relate to each type of license issued by TDLR.

TDLR presented the applicable guidelines to the Massage Therapy Advisory Board at its meeting on July 17, 2018 and received the Board’s recommendation of approval. The Commission adopted the amendments to the guidelines at its meeting on September 25, 2018, pursuant to Texas Occupations Code §53.025(a).

Adoption of Repeal of Duplicate Administrative Rules

The Texas Commission of Licensing and Regulation adopted the repeal of inactive rules regarding the Massage Therapists program (16 Texas Administrative Code, Chapter 147, §§147.1 - 147.55).

The adoption justification may be viewed on TDLR’s web site.

Adopted Administrative Rules

The Texas Commission of Licensing and Regulation adopted amendments to existing rules regarding the Massage Therapy program (16 Texas Administrative Code, Chapter 117, Subchapter A, §117.2; Subchapter C, §117.20; Subchapter E, §117.40; Subchapter F, §§117.50, 117.60, and 117.62; Subchapter G, §117.80 and §117.82; Subchapter J, §117.111; and new rules Subchapter B §§117.10 - 117.14).

The adoption justification may be viewed on TDLR’s web site and the adopted rule chapter will be made available upon its effective date of May 1, 2018.

MBLEx Exam Changes Effective July 1, 2018

The content of the massage therapist licensing exam is changing. The primary change, effective July 1, 2018, is that applicants will no longer be tested on the history and culture of the profession. A full list of all upcoming changes to the exam content is available on the FSMTB Exam Content page. There are no changes to the testing process.

Proposed Repeal of Duplicate Massage Therapy Administrative Rules

The Texas Legislature enacted Senate Bill 202 (S.B. 202), 84th Legislature, Regular Session (2015), which transferred regulation of the Massage Therapy program from the Texas Department of State Health Services (DSHS) to the Texas Department of Licensing and Regulation (TDLR). To complete the implementation of S.B. 202, TDLR transferred the previous Massage Therapy program rules from Title 25, Chapter 140, Subchapter H to Title 16, Chapter 147. TDLR is now proposing the repeal of the transferred rules located at Chapter 147, §§147.1 - 147.55. The rules proposed for repeal are obsolete.

On August 18, 2017, the Texas Commission of Licensing and Regulation (Commission) adopted its own set of rules for the Massage Therapy program located at 16 TAC, Chapter 117. The Commission’s rules were effective November 1, 2017, (42 TexReg 4991).

This proposed repeal does NOT affect the current Massage Therapy program rules which were adopted by the Commission on August 18, 2017, located at Title 16, Chapter 117.

View the repeal proposal

TDLR will accept comments on the proposal until March 5, 2018. Comments may be submitted by email to erule.comments@tdlr.texas.gov.

Notice for All Schools and Educational Programs Licensed by TDLR

As of September 1, 2017, House Bill 1508 requires that all entities providing educational or instructional programs that prepare a student for an occupation or vocation requiring a TDLR license to:

    1. Inform the student or program participant that eligibility for a TDLR license could be affected by the person’s criminal history;
    2. Notify students and participants that TDLR is responsible for having in place guidelines regarding a license applicant's criminal history, and to include information on an applicant's ability to be licensed under those guidelines;
    3. Provide students with information on other state or local restrictions that would affect the student’s eligibility for an occupational license issued by TDLR;
    4. Inform students of the student's right to request a criminal history evaluation letter from TDLR;
    5. Provide all persons who enroll in their program with notice of the requirements as described above, regardless of whether or not the person has been convicted of a criminal offense. 

An educational entity or training program operator who fails to provide this information to a person who is enrolled in their course may be liable for tuition or application fees paid by any student who is denied a TDLR license due to the existence of a criminal conviction.


Advisory Board Meetings

CANCELED - Next Meeting - April 20, 2020

The Massage Therapy Advisory Board meeting scheduled for Monday, April 20, 2020 is canceled. When the meeting is rescheduled, the date will be posted online.

November 19, 2019 Meeting

The Massage Therapy Advisory Board met November 19, 2019 in Austin. The agenda and staff reports (PDF) are available online. The meeting was archived and is available on TDLR's YouTube channel.


Transition from DSHS to TDLR

1. When did the transfer happen?

The Texas Department of Licensing and Regulation (TDLR) assumed all activities relating to the Massage Therapy program including licenses and renewals, customer service and enforcement on November 1, 2017.

2. Now that the transfer is complete, will I need to get a new license issued by TDLR?

No. The license you have now, issued by the Texas Department of State Health Services (DSHS), remains valid until its expiration date. When you renew, you will receive a TDLR license.

3. Have the rules changed?

Yes, TDLR adopted rules for all of the transferred programs. Most of the newly adopted rules are very similar, but some changes have been made. The TDLR health profession rules became effective on November 1, 2017.

4. What is going to happen with open complaints and cases?

If you filed a complaint with DSHS or had a complaint filed against your license and it was not resolved by the transfer date, TDLR assumed responsibility for the case. You should have already received notification by mail that your complaint was transferred to TDLR.

5. How do I stay informed about changes impacting me?

You have several options to stay connected:

  • Email updates - Sign up for email updates to receive notices about rules, the law, fees, examination requirements, meetings and more. Email updates are the best way for you to stay informed.
  • Meetings - TDLR’s advisory board and Commission meetings are available to watch online live or later at your convenience.
  • Facebook and Twitter - TDLR has a Facebook page and Twitter account dedicated to TDLR Health Professions.

6. Why was my license expiration date extended? Will I have the same expiration date in the future?

To ease the transition, DSHS extended the expiration date by two months for licenses previously set to expire in September, and October, and November 2017. For example, if your original expiration date was September 30, your new expiration date is November 30. If your license was extended, you will continue to renew your license in the new expiration month in the future. Licenses in counties affected by Hurricane Harvey were also extended by DSHS.

7. Will I have to renew on a different schedule?

You will renew on the same schedule unless your license expired in August, September or October 2016. Licenses expiring in those months were extended for two months to ease the transition from DSHS to TDLR. In addition, licenses in counties affected by Hurricane Harvey were also extended by DSHS. If your license was extended, you will now renew in your new expiration month for future renewals. Your license expiration date will not return to your original expiration month.

8. Why were licensing programs transferred from DSHS to TDLR?

The transfer is the result of a change to Texas law. In 2015, the Texas Legislature passed Senate Bill 202, which authorized the transfer of thirteen licensing programs from the DSHS to TDLR.