Are All Continuing Education Contact Hours Equal?, by Patti Biro, MASSAGE MagazineEven massage therapists and bodyworkers who have been in practice for many years are sometimes confused by the terms continuing education unit, contact hour, CE hour, CE credits or CEU. The confusion is understandable as many providers, some states and marketing materials tend to use the terms interchangeably. There is in fact a difference between these terms, and this article will help you to navigate the CE waters.

First, all of the above terms apply to the measurement of continuing professional education activities both for live programs, such as conferences, seminars or hands-on courses. The terms also apply to self-study courses or journal articles, which are used for independent study by reading, viewing instructional materials ,such as DVDs, listening to audio seminars or participating in distance learning activities, such as Web-based instruction.

The marketing materials for a continuing professional education activity you are considering should clearly state the number of hours you can earn by completing the course and the course requirements. For longer conferences or seminars, the contact hours can be broken down by the sessions you wish to attend and may not require you to attend the entire conference or seminar.

What is a CEU?
Perhaps the most confusing and misused term is CEU, which means a continuing education unit. This term is used primarily in academic settings at the college and university level and is a designation of course time or instruction where one hour is equal to 0.10 CEUs. This division by 10 means that 10 hours of instruction (or participation) is  equal to one CEU unit. If you see the term CEU used, it should always contain the decimal point to show the fraction of hours. The CEU term is not generally used when calculating instructional hours for massage and bodywork continuing professional education. The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) does not use the term CEUs. Continuing professional education providers recognized by the NCBTMB promote the use of the terms continuing education hour or CE hours. 

The use of the term CEU as a generic reference to any and all continuing professional education activities only promotes confusion. Be sure to read the course contact hour description and ask questions of the CE provider if the CE contact hours are not clear to you.

Are all instructional hours created equal?
The simple answer is no. While the standard of an instructional unit is generally 60 minutes, this can vary from state to state. The NCBTMB standard is 60 minutes, or 50 minutes of instruction plus a 10-minute break. Lunches, social hours and other noninstructional time are not eligible for continuing professional education credit. Most states and professional organizations also have a minimum number of hours that are eligible for professional education credit.  In most cases, courses or classes shorter than one hour are not allowed. By the same token, a 75-minute session at a conference may only be able to offer one hour of continuing education because there is no provision for units of  instruction that are less than one hour.

How do I know what I need?
States that require continuing professional education will provide the number of hours and requirements on their Web sites in the massage therapy licensing section. There is generally a link to a “Continuing Education” or “Renewal” section, which will provide a definition of what is accepted, the specific types of activities that are allowed and what the unit of measurement is for your state. Some local agencies, such as the specific city or county you practice in, may have additional requirements. 

Because regulations and guidelines do change, it is a good idea to check for updates from your state, county or city on a regular basis and always before registering for a specific course to make sure it will be acceptable for your license renewal.

If you are nationally certified or a member of a national organization that requires continuing professional education to maintain your membership or certification, you should become familiar with the organization’s requirements. In some cases, a specific course may meet all the requirements for a national organization but may not be acceptable to the guidelines of the state.

What else do I need to look for?
Many states will accept self-study or distance learning activities for the required number of continuing education contact hours. However, each state can set the percentage or number of hours that can be obtained through self-study courses. Checking the number of hours allowed through self-study or distance education before registering for a course can save you the expense and disappointment of taking a course you cannot use to renew your license.

Anything else?
More and more states are requiring a specific number of hours be completed in mandated courses, such as ethics, state regulations or CPR. The number of hours and the specific content of these required courses are listed in the continuing education requirements for the renewal of your license. For example the state of Tennessee requires all massage therapists complete a two-hour course of federal and Tennessee statutes regarding the practice of massage and massage establishments prior to the renewal of a massage-therapy license.


Patti Biro, Are All Continuing Education Contact Hours Equal?, MASSAGE MagazinePatti Biro is an educator with more than 25 years experience in the design, development and planning of continuing professional education for health and wellness professionals. She is a NCBTMB-recognized provider of continuing education. Biro is the founder of Elder-ssage™: The Art and Science of Massage for the Aging Adult, which emphasizes the cross disciplinary use of massage for the older adult. She can be reached at or on the Web at