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

New Human Trafficking Awareness Signs Required No Later Than January 1, 2022

Beginning January 1, 2022, all cosmetology businesses - including specialty salons, mobile salons, and schools – and all massage establishments and massage schools are required by Texas law to display a sign with information about available services and assistance to victims of human trafficking, including information on how to report suspicious activity to the Texas Department of Public Safety. The sign has information in five languages.

TDLR has created a sign for you to download and use:

Download the human trafficking sign

This requirement was put into place by the 87th Texas Legislature in 2021. Please download the sign and display it in your business. The sign must be placed in a prominent location where it can be seen by the public.

Background

House Bill 3721, which went into effect on September 1, 2021, requires all cosmetology businesses and massage establishments and schools to display a sign concerning services and assistance to victims of human trafficking. The signs, which had already been required, now must also include information on reporting suspicious activity to the Texas Department of Public Safety. The signs must be displayed no later than January 1, 2022.

More information on how to combat human trafficking:

Continuing Education Requirements

HB 1560, the Sunset legislation for the Texas Department of Licensing and Regulation, repealed Occupations Code §455.0571 from the Massage Therapy statute, and transferred authority regarding the continuing education requirements to TDLR’s enabling statute, Chapter 51 of the Texas Occupations Code.

Please note that no changes were made, and Massage Therapy program licensees are still required to obtain continuing education (CE) credits as specified in the program rules.

Temporary Distance Learning Provisions Ending December 15

On March 12, 2020, March 31, 2020 and May 21, 2020, TDLR enacted temporary distance education provisions in response to the COVID-19 pandemic. These temporary provisions allowed licensed massage schools to offer distance education because many schools could not provide in-person classes under state or local COVID-19 restrictions.

On May 28, 2021, Governor Greg Abbott signed Senate Bill 1130 into law. The bill amended the Massage Therapy statute to allow licensed massage therapy schools a new delivery method to offer 250 hours of distance learning education on specific subjects to their students. However, the statute still requires schools to provide 250 hours of hands-on training under the supervision of a licensed massage instructor. Accordingly, TDLR’s temporary provisions allowing distance learning and a portion of the hands-on training requirement to be taught online will end on December 15, 2021.

Beginning on December 15, 2021, schools must ensure that students complete 250 hours of in-person, hands-on instruction with a licensed massage therapist instructor as prescribed in Tex. Occ. Code § 455.156. This means that TDLR will no longer accept distance education as a means of delivering the required hands-on instruction.

TDLR has proposed amendments to existing rules for the Massage Therapy Program rule at 16 Texas Administrative Code, Chapter 117. If adopted, the rules will have an effective date of January 1, 2022.

Call for Subject Matter Experts (SMEs) to Participate in the Development of the Texas Massage Therapist Licensing Examination

The Texas Department of Licensing and Regulation (TDLR) is looking for SMEs to volunteer to serve on the Massage Therapist Examination Review Committee (ERC).

The ERC creates, updates, evaluates, and references exam content. 

Participation of knowledgeable SMEs will ensure the validity of the Texas Massage Therapist Licensing Exam.  

Participants must be willing to sign a confidentiality document agreeing not to disclose examination content, materials, or discussions. Participants must also be willing to travel to Austin for all meetings.

To view the minimum qualifications and to apply, download the Exam Develop Committee Application (PDF).  The deadline to submit the application is November 8, 2021.

Reminder on Curriculum for All Massage Schools and Students

TDLR reminds all massage schools and students in Texas that curriculum must be offered in accordance with current state laws and rules found in Texas Occupations Code, Chapter 455 and in 16 Texas Administrative Code, Chapter 117. This includes requirements that curriculum be taught by a TDLR-licensed instructor at a TDLR-licensed massage school or a state-approved educational institution.

On May 28, 2021, Senate Bill 1130 was signed into law that allows massage schools to provide specific portions of the required curriculum using distance learning.

Rules are currently being discussed to implement this law change. You are encouraged to sign up for email updates to stay informed.

The current laws and rules can be found under the Law & Administrative Rules tab to the right.

TDLR Health Monitor – August 2021 Edition

Articles in this August 2021 edition of The Health Monitor includes updates on:

  • 2021 Legislative Session
  • Commissioner Spotlight
  • Athletic Trainers Mark 50 Years
  • Revised Massage Therapy Sample Consultation Document Available
  • How to File a Complaint

Proposed Rule Changes

The Texas Department of Licensing and Regulation proposes amendments to existing rules for the Massage Therapy Program rule at 16 Texas Administrative Code, Chapter 117, Subchapter A, §117.2, Subchapter F, §§117.50, 117.55, 117.58, 117.59, 117.62, 117.66, 117.67, and 117.68, Subchapter G, §117.82, and Subchapter H, §§117.91 and 117.92. The proposed rules implement Senate Bill 1130, 87th Legislature, Regular Session (2021), which expressly allows massage schools to teach certain subjects through distance learning. The proposed rules also implement House Bill 1540, 87th Legislature, Regular Session (2021), which amended the definition of “sexual contact” in the Massage Therapy statute.

The proposed rules were published in the August 20, 2021, issue of the Texas Register (46 TexReg 5125). The Department will accept comments on the proposal until September 20, 2021.

The Department encourages anyone interested in the Massage Therapy Program to review the rule proposal online. Comments may be submitted electronically on the Department’s website.

Fingerprinting Reminder

State law requires that all Massage Therapists, Schools, Instructors & Establishment owners submit their fingerprints for a national criminal history check by Sept. 1, 2021 in order to renew their license.

TDLR records show that you have not yet submitted fingerprints as part of the license renewal process. Don't wait until the last minute – read more on the fingerprinting process.

All Massage Therapists also are required by state law to complete human trafficking prevention training in order to renew their license.

Please note: if you have already submitted your fingerprints for one type of massage therapy license, you do not have to submit them again to renew a second or third type of massage therapy license. If you are renewing multiple types of TDLR licenses, you can submit a copy of the receipt from the first set of fingerprints you obtained. We cannot accept fingerprints submitted to another agency for non-TDLR licenses.

Revised Massage Consultation Document Available

The Texas Department of Licensing and Regulation has released a revised Massage Consultation Document for use by Massage Therapists in Texas.

Texas Massage Therapy rules require that massage therapists provide a consultation document:

  • before the first massage therapy session;
  • if the client’s reason for seeking massage therapy changes and any information in 16 TAC, Section 117.91(a)(1-4) is modified; and
  • before each session in which breast massage will be performed unless written consent is received on a separate document.

Use the checklist provided in the document to ensure that your consultation document meets all current TDLR requirements. Failure to use a consultation document that meets current requirements and/or in the manner prescribed may result in disciplinary action against you.

For questions, please contact TDLR via webform at https://www.tdlr.texas.gov/help.

Updated Guidance for Vaccinated and Unvaccinated Individuals

The Texas Department of State Health Services has released the following Updated Guidance for Vaccinated and Unvaccinated Individuals. https://open.texas.gov/

Please note that business owners may choose to require additional safety protocols related to COVID-19 safety.

TDLR Health Monitor – May 2021 Edition

Articles in this May 2021 edition of The Health Monitor include updates on:

  • 2021 Legislative Session
  • Emergency License Extensions in Response to COVID-19 Delays
  • Meet Commissioner Callas
  • New Open Records Portal
  • New Way to Pay for Online Applications
  • Fingerprint Reminder for Massage Therapy Licensees

Harassment of and Violence Toward Massage Therapists

Dear Massage Therapy Licensee,

We share your concern about recent and ongoing harassment of and violence toward massage therapists, including actions against Asian-American and Pacific Islander licensees… [continue reading]

Estimado Licenciatario de Terapia de Masaje,

Compartimos su preocupación ante el reciente acoso continuo y la violencia hacia los masajistas, incluyendo las acciones contra los licenciatarios asiático-americanos e isleños del Pacífico… [seguir leyendo]

เรียน ผู้รับใบอนุญาตการนวดเพื่อการบำบัดรักษา

เราตระหนักถึงความกังวลของท่านเกี่ยวกับการล่วงละเมิดและความรุนแรงที่มีต่อผู้ประกอบอาชีพนวดเพื่อการบำบัดรักษาที่เกิดขึ้นเมื่อไม่นานมานี้และต่อเนื่องไปในอนาคต รวมถึงการปฏิบัติต่อผู้รับใบอนุญาตชาวเอเชีย – อเมริกันและชาวเกาะแปซิฟิก [อ่านต่อ]

마사지 치료사 면허 소지자분들께,

아시아계 미국인 및 태평양 섬 주민 등 마사지 치료사 면허 소지자에 대한 지속적인 괴롭힘 및 폭력이 발생하고 있으며, 이에 대해 저희는 깊은 우려를 표합니다.  [계속 읽기]

亲爱的按摩治疗师执照持有者:

我们与您一样,非常关注最近以及持续发生的针对按摩治疗师的骚扰和暴力事件,包括针对亚裔美国和太平洋岛国执照持有者的行为。 [继续阅读]

Kính gửi Người Được Cấp Phép Trị Liệu Mátxa,

Chúng tôi chia sẻ quan ngại của bạn về tình trạng quấy rối và bạo hành gần đây và đang diễn ra đối với các nhà trị liệu mátxa, bao gồm các hành độn chống lại những người được cấp phép là Người Mỹ Gốc Á và Người Đảo Thái Bình Dương.   [Tiếp tục đọc]

Commission Action on Administrative Rules

Commission Adopts Administrative Rules

The Texas Commission of Licensing and Regulation (Commission) adopted amendments to existing rules at 16 Texas Administrative Code, Chapter 117, Subchapter C, §117.20 and §117.24; Subchapter D, §117.30 and §117.31; Subchapter G, §117.82; Subchapter H, §§117.90, 117.91, and 117.92, regarding the Massage Therapy program. The adopted amendments implement House Bill 2059, 86th Legislature, Regular Session (2019), which requires completion of a human trafficking prevention training course. The adopted rules also address procedures related to breast massage of a female client and make additional clean up and clarification changes.

The adoption justification was published in the March 26, 2021, issue of the Texas Register (46 TexReg 2003). The updated rule chapter will be made available upon its effective date of April 1, 2021.

Commission Withdraws Proposed Administrative Rules

The Commission also withdrew rules that were originally proposed as part of the rule changes discussed above. The Commission withdrew the proposed new rule at Subchapter D, §117.35 and the proposed amendments to the existing rule at Subchapter F, §117.64. The withdrawn rules notice was published in the March 26, 2021, issue of the Texas Register (46 TexReg 1975).

Revised Checklists For Reopening Texas

Below are the revised guidelines created by the Governor’s Strike Force to Open Texas:

Governor’s Executive Order Regarding Masks and Business Capacity

The Governor’s Executive Order removes state-imposed restrictions on business capacity and masks. Effective Wednesday, March 10, there are no COVID-19 related operating limits for any business or other establishment.

Individuals are strongly encouraged to wear masks over the nose and mouth wherever it is not feasible to maintain six feet of social distancing from another person who does not live in the same household. (Please note that counties in trauma service regions with hospitalization rates above 15% for 7 days can implement other requirements.)

According to the Governor's executive order, nothing prevents businesses – including hair, esthetician and nail salons, lash salons, barber shops, barber or cosmetology schools, laser hair establishments or massage establishments – from requiring employees or customers to follow additional hygiene measures, including wearing a mask.

Driver Education schools may choose to require employees or students to wear masks and to social distance.

The order also strongly encourages all Texans to use good-faith efforts and available resources to follow the DSHS health recommendations.

Call for Subject Matter Experts

TDLR is seeking subject matter experts (SMEs) to assist our Enforcement Division with complaint case reviews. SMEs review complaint cases, generally involving standard of care issues, during the investigation stage of the enforcement process.

We currently have a shortage of Behavior Analyst, Podiatrist, and Speech-Language Pathologist SMEs.

If you are interested in becoming a SME, please complete the Expert Witness Application. Once the application is submitted, you will receive a questionnaire to complete and return. Documents are screened and contracts are issued to approved SMEs.

All SMEs receive training on their role in reviewing complaint cases. Tasks may include the following:

  • Reviewing documents and statements collected by investigators.
  • Writing a report stating an opinion as to whether the respondent violated a rule or law in the provision of care to a client.
  • Answering specific questions from the prosecutor about the case.
  • Testifying as a witness for TDLR at hearings.

Our mission is to protect the citizens of Texas and the hard-working members of your profession. We cannot do that without your specialized knowledge of the complexities of your profession. Please consider becoming a SME today.

TDLR Health Monitor – February 2021 Edition

Articles in this February 2021 edition of The Health Monitor include updates on:

  • 87th Session of the Texas Legislature
  • Emergency License Extensions in Response to COVID-19 Delays
  • Program Rule Changes
  • Call for Subject Matter Experts
  • New HHSC-Approved Human Trafficking Training Courses Available

Notice to prospective licensees, current licensees renewing their licenses, and stakeholders

Applicants can apply for new licenses and renew licenses online. TDLR strongly encourages you to take advantage of the opportunity to apply or renew online. The process is secure and easy to use – and faster than submitting paper-based applications and supporting documents, especially as TDLR deals with significant staffing issues related to COVID-19.

  • Applications submitted online can take 30 days to process once TDLR receives all required documents.
  • Applications submitted by mail may face significant delays, which may take up to 90 days once TDLR receives all required documents.

Access the online licensing system here. If you need to submit a document outside of the online application, please scan the document and send it to TDLR using our online customer service form.

If you need to submit a transcript, please ask your university to send electronic transcripts to TDLR at cs.transcript@tdlr.texas.gov instead of mailing in an original or certified copy of an original transcript. If your need to submit other documents, such as receipt of fingerprint submission, please scan the document and send it electronically to TDLR using our Customer Service form.

Thank you for helping us process your application or renewal more quickly.

Palms Enrollment Training Video

Effective September 1, 2020, all massage students enrolled in a licensed massage school are required to hold a student permit. PALMS is the portal that was created for massage schools to enroll, report hours and drop students.

These training videos  provide step by step instructions to report student hours, drop / withdraw students and change student contact information.

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 massage establishment:

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.

These provisions will remain in place until further notice.

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.

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 contact the Education and Examination division 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.

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 contact the Education and Examination division 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

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).

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.

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

October 18, 2021

Thet Massage Therapy Advisory Board met October 18, 2021 at 1:00 p.m. The meeting was archived and is available on TDLR’s YouTube channel. The agenda and staff reports are available online.


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.