How do you become a massage therapist? The process is simple and consists of three steps:

Step 1: Find, enroll in and complete a training program at a certified massage therapy school. Chose a school in the state in which you plan to practice.

Step 2: Meet all the requirements of your state or municipality to practice massage therapy. To meet most state requirements will require passing the Massage & Bodywork Licensing Exam (MBLEx), and any state or local legal or health tests.

Step 3: Take and pass the MBLEx exam and clear all the business licenses, insurance, background check and regulatory hurdles.

Once you complete all three steps, you’ll be a licensed massage therapist, and you can start finding, scheduling and seeing clients. This process might sound simpler than it is, but even with the challenges you’ll face along the way, it’s a very rewarding career choice.

Where You Can Practice Massage

People become massage therapists for different reasons. They may have discovered early on that they had a knack for back rubs or massage. Other people may not have even considered massage as a career option until later in life.

Some people decide to become a massage therapist after having received their first massage. Perhaps they were in an accident and discovered how great massage was during their rehabilitation.

Some people just want a career change. Others may be a recent high school graduate looking for a career—a career in which they’re in control of their time.

Massage therapy is a great profession no matter your age. You can be just out of high school, about to enter retirement or any age in between.

As far as locations, new therapists can rent office space by the day, or even by the hour in many places. They don’t even need to own their own table at first.

Therefore, it’s not necessary to have an office right away. If you do want an office, you can share space, convert a room in your home, or find affordable options.

Some massage therapists are content to do out-calls, going to a client’s business or home to work on them rather than having an office. They can even charge extra for the travel time.

Some outcall massage therapists can work for one of the popular massage app companies that offer healthy touch on demand, or offer corporate massage to companies' employees.

The options for the type of locale in which a massage therapist can work are practically endless. You can work for an established massage practice, or for a physician or chiropractor, or a college or university’s sports team.

There are massage therapists in physical therapy clinics, hospitals and beauty salons. You can work on a cruise ship or in a massage franchise. Or you can choose to pursue only a few clients as part-time income for your current job or during retirement.

Many massage therapists chose to take their practice on the road,working at rodeos, horse shows, marathons or extreme sports competitions. (Getting certified in several states may take a lot more effort if you want to do this, but it’s worth the effort if you want to travel and make money on the road.)

When you work for yourself, you control your hours, the number of clients you want to see and the modality you practice. If you only want to work three days a week and play the other four, that’s possible—if you have another income stream or have completed the advanced education necessary to charge a premium rate for your services.

Plus, few careers are as satisfying as one in which you help people feel better.

If you naturally like helping others, working with your hands and being your own boss, massage therapy is hard to beat.

How Much Do Massage Therapists Make?

Depending on where you live and what services and products you sell, your income as a massage therapist depends on you.

Some experienced massage therapists with a practice and several massage therapists working for them and who retail self-care products in addition to offering massage can make a six-figure income.

Solo practitioners who work part-time may bring in only a few thousand dollars a year.

However, NaturalHealers.com found that according to the current Occupational Outlook Handbook from the U.S. Bureau of Labor Statistics (BLS), "the median salary for massage therapists is $39,860 per year.”

However, this salary can vary based on a number of factors, according to All Psychology Schools, which include how specialized you are in your field, the location of your practice, and even how long you have been in your field.

The BLS reports that the best-paid 10 percent in the profession made $74,870, while the lowest-paid 10 percent made $19,720, according to U.S. News & World Report.

Here are the five areas in the U.S. with the highest annual mean wage rates for massage therapists:

Anchorage, AK                                               $86,670

Kingston, NY                                                $85,630

Fairbanks, AK                                                 $76,470

Kahului-Wailuka-Lahaina, HI                        $76,260

Eugene, OR                                                    $70,200

The states and districts that pay massage therapists the highest mean salary are Alaska ($85,110), New York ($62,270), Vermont ($57,260), Delaware ($57,000), and Washington ($55,920).

With some massage therapists earning almost six figures, why do so many other massage therapists struggle financially?

An unwillingness to confront the reality of running a business could be one reason some massage therapists fall behind.

"Running a business requires more than passion," said massage-and-spa business consultant Kamillya Hunter, quoted in the MASSAGE Magazine article, "This is What the Highest-Earning Massage Therapists Have in Common."

"Many massage therapists know exactly why they went into the field of massage—typically, because they want to share the benefits of massage, help others or just simply love the field," she continued.

"Those reasons should not be confused with why you chose to start a business, because they are not the same … if you do choose to run a business, you must invest the same time and passion into learning and strengthening basic business principles as you have into learning and practicing your techniques, because providing a great service does not guarantee a successful business," she said.

Another reason for not making enough as a massage therapist could be “one's attitude about money,” said massage business expert Rebecca de Azevedo Overson, quoted in the same article, wherein the massage therapist doesn’t want to charge what they are worth, decides to lower their rates to compete with other therapists, or feels that product sales is not ethical.

These are they types of attitudes that must be overcome to succeed in massage therapy, according to Overson.

Let’s break down those three steps for how to become a massage therapist even further. Let’s begin with:

Step 1: Find a Massage Therapy School

Find, enroll and complete a training program at a certified massage therapy school. Chose a school in the state in which you plan to practice.

You will need to find, enroll in and complete a training program at a certified massage therapy school that will qualify you to practice in the city and state you choose.

However, buyer beware. Not every massage program or school, even some of the accredited ones, are legitimate. These for-profit colleges and schools are predatory lending scams hiding behind what they promise is an education that will prepare you for a career in any of a dozen fields, including massage.

The school promises you something—in this case a massage certificate, and then encourages or even coerces you, into taking out a loan you can’t afford, or don’t need. This is all done in order to enroll you in a program that can’t or doesn’t deliver the results they’ve promised you.

That leaves you unable to pass licensing exams, or earn the wages you were promised when you enrolled, yet leaves you with enormous school loan debt.

Since 2017, massage schools across the county, in particular schools such as Corinthian Colleges and other for-profit career colleges, have been, or are being investigated, sued, and shut down. Some are being targeted by class-action lawsuits by former students.

Others are being forced to return tuition and fees to former students. In 2015 a federal judge in Illinois ruled that Corinthian “engaged in deceptive practices” by misleading students about their career prospects,” and ordered the school to repay students. It’s been three years, but predatory lending scams by for-profit schools continued—in part due to the overturning of Obama-era education reforms.

States with poorly performing schools can now, The New York Times says, use the lack of regulations to shield poorly performing schools from scrutiny. This is particularly troubling when for-profit programs and schools impact the poor, the disabled, non-English speaking students and young students.

In August 2018 Betsy Devos, the U.S. Secretary of Education, scrapped two regulations that would have forced for-profit colleges to prove that the students they enroll could find gainful and living wage employment once they graduated from the school.

The two regulations are known as, “the Gainful Employment rule,” which requires that for-profit schools show their graduates are indeed making a living wage after they graduate, and “the Borrower Defense rule,” which the Federal Student Aid Department states, “Borrowers may be eligible for forgiveness of the federal student loans used to attend a school if that school misled them or engaged in other misconduct in violation of certain laws.”

These two regulations, among others, are meant to protect students from predatory lending.

What is predatory lending? According to Debt.org, predatory lending is “any lending practice that benefits the lender, and imposes unfair loan terms on the borrower.”

The controversy is ongoing, but until the debate is settled, it’s smart to do your due-diligence research when considering any massage school, college or student loan program.

Once you do find a potential college or program, properly vet them for abuses and predatory lending practices, and enroll, you can expect your program to take at least a year to complete, although some full-time programs can graduate a student in six to eight months. Longer programs (1,000-plus hours) may take up to two years.

No matter what state you live in becoming a licensed massage therapist begins with your massage school education. It’s after graduation that things can get challenging, so picking the right school is important.

You want to attend a nationally accredited program where possible. Look for schools that have accreditation by the U.S. Department of Education (USDE).

This ensures the education provided meets an acceptable level of quality training. There are a lot of accrediting bodies that give voluntary accreditation of massage schools or programs, including:

• Accrediting Bureau of Health Education Schools

• Accrediting Commission of Career Schools and Colleges

• Accrediting Council for Continuing Education and Training

• Accrediting Council for Independent Schools and Colleges

• Commission on Massage Therapy Accreditation

• National Accrediting Commission of Cosmetology Arts and Sciences

One of the most important reasons for attending a national or federally accredited school is financial aid.

Accreditation by one of the organizations above opens the way to federal loan and grant eligibility. Only students attending federally accredited schools are eligible for this financial support.

 Choosing the Right Massage School

Depending on what state you’re in, there are many massage school options,including community colleges, private schools and university programs. Use to help find the right school for you.

Where possible, attend a nationally accredited massage school or program. There are many state programs and schools, including college programs, that offer accredited classes, but graduation from a nationally accredited program will make things easier for you throughout your career.

Don’t just pick a school because it is close to you.

Visit several schools to get a sense of what is out there and to get a feel for each school. Does the school environment feel warm and engaging? Do the students who are there seem friendly, professional and focused on their classes? Does the school representative seem to understand the massage profession and how their school's training prepares you for the profession?

How to Research and Review Massage Therapy Schools and Programs

There are more than 300 massage schools in the U.S. Some are better than others in instruction, depth and variety of classes, or the instructors and curriculum, graduation rates and fees.

You are the only one who can determine which school is best for you and why it’s better for you than another. You can do a lot of your research online, so begin there. Visit a school’s websites. Read reviews and look at their curriculum.

Go to your state’s website to find out what they require for you to practice in your state. Once you have some basic information about a few schools, attend an open house or orientation. Ask for a tour of the school.

Ask for names and contact information of recent graduates and talk to them about their experience with the school. Ask the school if you can sit in on a class, and meet and interview some of their instructors.

All massage schools have a different personality or culture. What may be a better ranking school may not be best for you because of their culture or approach to massage.

Consider which school best matches your career intentions, personal beliefs, goals, personality, schedule and, of course, your budget.

Meet with an admissions counselor. Admissions counselors want to do one thing: sell you on attending their school. That’s fine, but make them show you why they’re the best for you. Have a list of questions for them. Don’t just show up and listen to a sales pitch. Ask such questions as:

• What are the state requirements for licensure?

• Does your program meet all the state requirements for education? Ask to see the list of requirements and the curriculum.

• How long does it take for the average student to graduate?

• What is the graduation rate at the school?

• Will the school help you study to pass the MBLEx exam?

• Are there tutors available?

• How much business information is taught?

• Is there a post-graduation support community for graduates?

• Is there a job board or career placement help for graduates? For how long?

• Can you come back and retake a class? Does the school maintain a list of graduates for people wanting referrals?

All schools are required to offer classes in the business of running a massage practice, but few spend as much time on this as you might need. Your massage therapy practice, as helpful and healing as it may be, is still a business. Success in running a practice means understanding the business aspects of what you do. Ask about how the school prepares its students for running a business.

• Does the school do background checks on its students?

• What financing does the school offer?

• What are the time requirements and when are classes scheduled?

• Who are your instructors? What are their massage credentials and experience?

• What student services does the school offer? (Such services might include tutoring, job placement and financial aid.)

• Will you need to provide supplies like sheets, your own table and lubricants?

If there is no nationally accredited program in your area, the school or program you attend must still be operating legally and meet the standards for your state, county and city.

Depending on your state’s requirements, you will need from 500 to 1,000 hours of education and may have to pass from one to four additional tests and licensing exams to get your massage therapy license.

In most states you’ll need to pass a background check, be fingerprinted and show proof of liability insurance, get a business license and earn an additional 10 to 20 hours of continuing education credits each year to maintain your license.

Don’t be frightened by the requirements of getting your license, but do take them seriously and start working to ensure you meet them all.

When you start looking for liability insurance, begin by referencing the Massage Liability Insurance Group.

Forty-three states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands currently license massage therapists.

As of 2018, only California, Minnesota, Vermont and Wyoming do not require a license to practice massage. Vermont has a house bill before its state legislature that would require the professional regulation of massage therapists by the Office of Professional Regulation.

Many city and county governments within each of these states have created their own laws pertaining to massage therapy certification and licensing. Even if the state doesn’t require you have a license, it’s a good idea to check with your local government before practicing massage.

Some states' cities and counties require both an MBLEx exam and a state exam.

The California Massage Therapy Council’s Certification

The California Massage Therapy Council (CMTC) issues voluntary certifications to massage professionals that meet legal requirements. That means you don’t need a license to practice massage therapy in California, but you can’t advertise that you do massage therapy either, not unless you get certified by taking the MLBEx.

California Business and Professions Code section 4611 makes it an unfair business practice for anyone not certified by CAMTC to use the titles: Licensed, Certified, Certified Massage Therapist, Certified Massage Practitioner, CMT or CMP.

CAMTC certification is voluntary, meaning it is not required by state law in order for a massage professional to practice their profession in the state.

However, an increasing number of cities and counties are requiring massage therapists to obtain CAMTC certification. Part of the reason for this is to combat human traffickers, who frequently use illegitimate massage therapy businesses as a front for illegal activities. (Such illegal activity takes place in all 50 states.)

Step 2: Meet All the Requirements to Practice Massage Therapy

Meet all the requirements of your state or municipality to practice massage therapy. To meet most state requirements will require passing the Massage & Bodywork Licensing Exam (MBLEx), and any state or local legal or health tests.

Massage therapists must have a massage license in each state in which they practice. That license must be renewed regularly.

Most states have a continuing education requirement in order for you to renew your license. As always, massage therapists need to make sure that they are practicing within the scope of their practice, which the state licensure laws define.


You need to make sure that you are following two things to renew your license: Education and testing. Each state has its own requirements in addition to educational requirements and the type of test required, and you need to make sure that you are following the rules and regulations that your state has outlined governing massage therapy.

Some states, including California, Hawaii and New York, require additional tests and testing requirements. Some states require a background check, having a liability insurance policy or completing continuing education or state-specific training every year.

The process can take some time, so it’s a good idea to start planning your path the day you enter massage school.

Each state varies in their requirements. Check with your state’s health licensing board, or your massage school to learn what you’ll need to do to set up your practice and advertise your services as a massage therapist in your community.

The process can take some time, so it’s a good idea to start planning your path the day you enter massage school.

Most states or cities require:

• Graduation from a state or nationally accredited massage school. As good as they may be, not all massage therapy programs or schools are accredited.

This may make it difficult to get your license after graduation. Some states won’t accept education credits from any school that is not nationally accredited.

Unaccredited schools rarely offer financial aid, and if they do, it’s at a higher interest rate than a federal school loan.

• Verification of graduation in the form of certified transcripts from your school

• A fingerprint-based criminal history background check

• A test of state laws and rules regarding massage therapy, in addition to the MBLEx

• Proof of liability insurance

• Some states have a language requirement, requiring proof of English proficiency

• A business license to conduct business

• Proof of CPR or Basic First Aid certification

What is the MBLEx?

MBLEx stands for Massage and Bodywork Licensing Examination. The MBLEx is a national exam most massage therapists must take and pass to be licensed to practice massage therapy in their state.

Remember, licensing isn’t optional. Even in the few states that don’t require the MBLEx there are still standards and state tests you must pass to practice massage therapy—and, again, even in the three states that don’t require the MBLEx, there are bills before each state house that will require the state to require the MBLEx before 2020.

Health professionals in most fields, including doctors, nurses, psychologists, physical therapists, anesthesiologists and phlebotomists, are licensed.

Licensure assesses the broad spectrum of core competencies required for a massage therapist to set up and operate a safe and effective practice.

So, licensure is a good thing.

Licensure is a regulatory process that ensures health practitioners are appropriately qualified and trained to practice on the public.

It ensures that the public trusts you and is more willing and confident about seeking out your services. They know you’re licensed and held to a certain standard of practice.

Besides gaining the confidence of the public, obtaining a license to practice a profession is legally mandatory, and state laws may provide for criminal or administrative penalties for unlicensed activity.

Massage boards and agencies across the U.S. indicated they needed a licensing examination that was state owned and operated. From its beginning in 2005, the Federation of State Massage Therapy Boards’ (FSMTB) goal was to work toward cooperation in implementing requirements, regulations and procedures to establish safe and effective massage therapy and bodywork practices around the country.

That is how the MBLEx came to be. It’s designed to provide a standard examination for students of massage for an entry-level professional scope of practice in gaining licensure.

According to the FSMTB, “the MBLEx exam was developed on behalf of its member boards for four reasons: (1) to offer the first standardized licensing exam for the massage and bodywork profession; (2) to facilitate professional mobility; (3) to give the regulatory community oversight over exam content, organizational policies and procedures pertaining to the exam; and (4) to significantly speed up the process between application and examination to avoid unnecessary delays in licensure.”

Taking the MBLEx

Have your massage school or massage therapy program submit your educational records, including your transcripts to the FSMTB. MBLEx applications are not complete for processing until educational records are received. The FSMTB advises the following about taking the MBLEx:

• It will take five business days for your application to be processed.

• Once you get your Authorization to Test, via, email, you must take the test with 90 days. If you don’t schedule with Pearson VUE to take the exam within that timeframe, you’ll have to start the process over—and that includes paying the $195 fee again.

• Your test results will be immediately available. The minimum passing score is 630.

“The content of the MBLEx exam reflect the broad spectrum of knowledge and core competencies identified by the profession for a safe and effective entry-level practice,” notes the FSMTB’s website.

The MBLEx is administered daily at test sites across the U.S. and its territories. After you are approved to take the MBLEx, you will receive an Authorization to Test (ATT) via email. You need to use this information to register for the exam date and testing location of your choice.“Candidates have two hours to complete the MBLEx, which is a 100-item, multiple-choice test taken on a computer,” according to the FSMTB. “Out of this timeframe, five minutes is allotted to a security and confidentiality agreement and five minutes is allotted to a brief survey.”

According to the FSMTB, “the MBLEx exam is a CAT, or Computer Adaptive Test.” This means before you can move forward to the next question, you must answer the question being displayed.

Unlike old-school paper exams where you could go forward and back answering the easiest questions first, then returning to those you needed more time on, you must answer the questions on the MBLEx exam as they are shown.

When a question is answered correctly, you'll be given the next question. That next question will be slightly harder. Each time you answer correctly, the level of difficulty will increase. If you answer incorrectly, the next question will be slightly easier.

This customization of questions ensures the exam meets the candidate's ability level.

Remember, the difficulty of each question is determined by how many questions you answer correctly; however, you must answer enough difficult questions to get a passing score.

When you’re ready to take the MBLEx exam you may apply online or by mail.

You are allowed a pen and paper while taking the test. The paper is issued by the examiner at the beginning of the test, and you must turn in all paper, including your notes, at the end of the test.

The MBLEx is not just a gateway you have to get through to get permission to practice your craft. When you, as a massage therapist, take, and pass this exam, you become part of a community of professionals who are dedicated to higher standards, competencies and skills.

Passing the MBLEx means you have demonstrated your knowledge, skills, and professionalism and are qualified to join your peers who have also proven their competency.

What the MLBEx Tests On

The MBLEx exam consists of 100 questions over seven concentrated areas of content:

• Client assessment and Reassessment and Treatment plans
• Benefits and Physiological effects of Techniques
• Pathology with Contraindications
• Areas of Caution and Special Populations
• Ethics- Boundaries-Laws & Regulations
• Guidelines for Professional Practice, Kinesiology, and Anatomy & Physiology

Effective July 1, 2018, According to the FSMTB’s website, which has a more detailed version of the outline below, the content outline for the MBLEx breaks down further the categories used for establishing the questions in the MBLEx and is as follows:

• 16-18 questions on Client Assessment, Reassessment, and Treatment 17% (Assessment)
• 14-17 questions Benefits and Physiological effects of Techniques 15% (Application)
• 13-16 questions on Pathology with Contraindications, areas of Caution, and Special Populations 14% (Pathology)
• 15-18 questions on Ethics, Boundaries, Laws & Regulations 16% (Professional)
• 13-16 questions on Guidelines for Professional Practice 15% (Professional)
• 11-13 questions on Kinesiology 12% (A&P)
10-12 questions on Anatomy & Physiology 11% (A&P / Body Systems)

Under each section heading is a further breakdown of the topics in that area that will be covered:

ANATOMY & PHYSIOLOGY (11%)
A. System structure
• Circulation
• Digestive
• Endocrine
• Integumentary
• Lymphatic
• Muscular
• Nervous
• Reproduction
• Respiratory
• Skeletal
• Special Senses
• Urinary

B. System function
• Circulation
• Digestive
• Endocrine
• Integumentary
• Lymphatic
• Muscular
• Nervous
• Reproduction
• Respiratory
• Skeletal
• Special Senses
• Urinary

C. Tissue injury and repair
D. Concepts of energetic anatomy

KINESIOLOGY (12%)
A. Components and characteristics of muscles
B. Concepts of muscle contractions
C. Proprioceptors
D. Locations, attachments (origins, insertions), actions and fiber directions of muscles
E. Joint structure and function
F. Range of motion
• Active
• Passive
• Resistant

PATHOLOGY, CONTRAINDICATIONS, AREAS OF CAUTION, SPECIAL POPULATIONS (14%)
A. Overview of Pathologies
B. Contraindications
• Site specific
• Pathology related
• Special populations
• Tools
• Special applications

C. Areas of caution
D. Special populations
E. Classes of medications

BENEFITS AND PHYSIOLOGICAL EFFECTS OF TECHNIQUES THAT MANIPULATE SOFT TISSUE (1A. Identification of the physiological 5%)
1A. Identification of the physiological (5%) effects of soft tissue manipulation
B. Psychological aspects and benefits of touch
C. Benefits of soft tissue manipulation for specific client populations
D. Soft tissue techniques
• Types of strokes
• Sequence of application

E. Hot/cold applications

CLIENT ASSESSMENT, REASSESSMENT & TREATMENT PLANNING (17%)
A. Organization of a massage/bodywork session
B. Client consultation and evaluation
• Verbal intake
• Health history form
C. Written data collection
D. Visual assessment
• General
• Postural

E. Palpation assessment
F. Range of motion assessment
G. Clinical reasoning
• Ability to rule out contraindications
• Client treatment goal setting
• Evaluation of response to previous treatment
• Formulation of treatment strategy

OVERVIEW OF MASSAGE & BODYWORK MODALITIES/ CULTURE/ HISTORY (5%)
A. History of massage & bodywork
B. Overview of the different skill sets used in contemporary massage/bodywork environments
C. Overview of massage/bodywork modalities

ETHICS, BOUNDARIES, LAWS, REGULATIONS (16%)
A. Ethical behavior
B. Professional boundaries
C. Code of ethics violations
D. The therapeutic relationship
E. Dual relationships
F. Sexual misconduct
G. Massage/bodywork-related laws and regulations
H. Scope of practice
I. Professional communication
J. Confidentiality
K. Principles

GUIDELINES FOR PROFESSIONAL PRACTICE (15%)
A. Proper and safe use of equipment and supplies
B. Therapist hygiene
C. Sanitation and cleanliness
D. Safety practices
• Facilities
• Therapist personal safety
• Client safety
E. Therapist care
• Body mechanics
• Protective gear (masks, gowns, gloves, etc)
• Self-care
• Injury prevention
F. Draping
• Safe and appropriate Communication
G. Business Practices
• Business planning
• Strategic planning
• Office management
• Marketing
• Hiring/Interviewing
• Documentation and Records
• Client records
• Business records

H. Healthcare and business terminology

By using the breakdown above you can see where the MBLEx focuses its questions, which should help you create a focus for your studies.

The highest concentration of questions is in the Professional Ethics and Guidelines section. The next highest concentrations are the A&P/Kinesio/Body and the Assessment and Application.

Other State-Specific Tests

MASSAGE Magazine has a page where you can find the tests and requirements you’ll need to get licensed in your state.

Just enter your state, and it will list the prerequisites, number of hours, education, training, reciprocal status, insurance renewal information and continuing education requirements for that state. Begin by reading the free Massage Liability Insurance Group Guide.

Hawaii and the state of New York are unique in that the MBLEx is not required for licensure.

Hawaii has its own exam that is administered after you have completed and submitted your license application. Dates for the Hawaii massage exam are already set and are administered on each of the islands.

New York State requires 1,000 hours from an institute of massage therapy that has been approved or accredited by the Education Department, as well as passing the state massage therapy examination.

According to MassageTherapyLicense.org, “California massage therapists are voluntarily certified by the California Massage Therapy Council (CAMTC). Certification standards went up in 2015. There is now just one level of credentialing open to new providers, Certified Massage Therapist, or CMT. To achieve the credential, a massage therapist must complete an approved educational program, pass an examination, and have an acceptable criminal background check.

“Some California massage therapists work under local licenses or permits. The CMT is not a state mandate. However, CAMTC notes that a professional who holds the credential is authorized to work anywhere in the state and will not need to meet additional requirements at the local level. A business license will be required in some cases; a license to practice will not.”

“Check your state, city, or county Department of Labor or Health Department regulators to find out the requirements to practice Massage Therapy. Therapists who live in unregulated states often obtain a passing score on the MBLEx exam from the Federation of State Massage Therapy Board (FSMTB) after graduation to ensure they can continue their career if ever they move out of state,” states Massage-Exam.com

“Some employment establishments may require a certification or license to apply to work for them as well,” Massage-Exam.com continues.

All the states that do not currently require licensure are looking at bills that have been introduced that will require licensing, from MBLEx or NCBTMB, in the future.

Transferring Your Massage License From State to State (Reciprocity)

Most states have some sort of massage therapy reciprocity application. This can be confusing since true reciprocity does not exist in the massage profession. That means you can’t literally “transfer” your license from state-to-state. You simply qualify to apply for a new license in your new state based on your training and education.

In most cases, states require education and an exam score, even from those that already have a license or verification, or certificate. This is most states, not all.

That means when you move from one state where you hold a valid license, you may or may not need to retake a test to practice in your new state. It all depends on the state’s reciprocity laws or rules.

And while it seems like a simple process, it’s not. Don’t wait until the week you move to find out what you’ll need to do to become licensed in your new state. While a lot of states do offer reciprocity agreements, each one has different requirements.

According to Massage Therapy Schools Information, these states offer reciprocity for massage therapists, either by applying for licensure by endorsement, or by reciprocal agreement:

Arizona, Alaska, Alabama, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, Washington, West Virginia and Wisconsin.

Some states won’t have a reciprocal agreement but will require you to provide information on the status of your current license if you apply for a license in their state.

States with or without reciprocal agreements may have a different distribution of the number of hours for each topic.

And, if you currently live in a state with lower education or testing agreements than the one you’re moving to, you’ll most likely be required to meet the higher standards.

Your new state will also require you to provide the same documentation (transcripts, background check, fingerprints, etc.) as your current state, as well as verification of your current license from the state you are currently licensed in.

Even with reciprocal licensing, you may still be required to take an in-state law exam or continuing education classes related to your new state’s laws and rules.

For states like California, New York and Hawaii that do not require the MBLEx exam for licensure, visit their website for details on reciprocity, certification and permits.

New York: New York Division of Professional Licensing Services Massage Therapy Phone: 518-474-3817, ext# 150. New York has its own massage therapist licensing exam.

You can also learn about New York State’s testing and massage certification.

Hawaii: "Hawaii will not accept a reciprocity exam such as the NCETM/TMB or MBLEx. If you wish to practice massage in HI, you must take the HI state Massage Exam." For more information on Hawaii’s test and massage certification.

Massage therapy in the United States is regulated on the state and local level. Are you a licensed massage therapist in one state? Do you want to move to another state? The bad news is you'll have to get a massage license from their state board to practice in that state, even if you're already a licensed therapist. In some states, you can get licensed by reciprocity, endorsement or credentials, but you'll still have to go through the licensing process again.

States Without Reciprocity Agreements

Even though massage therapists take the same MBLEx, Many states—including Arkansas, Connecticut, Hawaii, Iowa, Maine, Maryland, Massachusetts, New Hampshire, Oklahoma, South Dakota, Texas and Utah—do not have reciprocal agreements.

This means you must show you meet their requirements for licensure and either retake the MBLEx or show proof of passing in your application.

Step 3: How to Study For The MBLEx

Take and pass the MBLEx exam and clear all the business licenses, insurance, background check and regulatory hurdles.

The number-one reason students put off taking the MBLEx or fail it when they do take it is fear.

Fear of failing, fear of freezing up during the exam, fear of not knowing the material that will be on the test, fear of forgetting what you do know are all fears that students of all ages and background give into.

But fear is the one thing that can be beaten if you know the secrets of studying for the MBLEx, and the five steps for banishing fear.

A: Don’t wait to begin studying for the MBLEx until you’ve graduated. By studying for the exam as you start attending classes, you’ll better understand the material you’re learning

You will also gain a broader understanding of the knowledge the MBLEx wants you to demonstrate, and you’ll feel more confident about taking the exam once you’ve graduated and are qualified to take the exam.

For instance, when you begin learning how to drape a client, review and learn about draping in the Guidelines for Professional Practice section.

If you review and practice each section on an MBLEx practice test as you’re learning the material in class, it will be easier when the time comes to study for MBLEx as a whole. You’ll be familiar with it, having reviewed it for months, and your fear about it will disappear.

B: Understand how the MBLEx exam is structured and what you’ll need to learn and know to take and pass the exam. This will make more sense as your classes proceed.

The terms and descriptions may feel intimidating now, but as you are introduced to each section in class, you’ll become comfortable with the language, terms and definitions.

The MBLEx exam is broken down into eight sections:

• Anatomy & Physiology (11%)

• Kinesiology (12%)

• Pathology, Contraindications, Areas of Caution, Special Populations (14%)

• Benefits and Physiological Effects of Techniques that Manipulate Soft Tissue (10)

• Client Assessment, Reassessment & Treatment Planning (17%)

• Overview of Massage & Bodywork Modalities/Culture/History (5%)

• Ethics, Boundaries, Laws, Regulations (16%)

• Guidelines for Professional Practice (15%)

C: Learn how to study. Most of us have our own way of studying. We may or may not have been taught the proper, or the most effective way to study in school. As a result, we just wing it, doing what we think is studying.

Fortunately, the number-one study method is the easiest to use. That method is flashcards. The number-two method is taking sample tests or quizzes.

You know how your teachers are always throwing pop quizzes? That’s because a pop quiz helps you learn the material better and faster.

If you give yourself sample quizzes rather than just reading the same information over and over, you’ll see how effective those quizzes are. Fortunately, many massage therapy textbooks have quizzes built into them, so make a photocopy and take the quiz, and take it several times throughout the course of your studies.

Flashcards may seem boring, but they work. More than any other study method, flashcards have been proven over and over to be the best method to learn new information and, according to the Brainscape Blog, here’s why:

Flashcards Engage “Active Recall.” When you look at the front side of a flashcard and think of the answer, you are engaging a mental faculty known as active recall.

What is active recall? Active recall is an attempt to remember a concept from scratch rather than recognizing it on a multiple choice quiz or trying to remember the page you read in your textbook.

To truly learn a new piece of information, you need to somehow trick your brain into activating new neural pathways and building new connections. It sounds time and labor intensive, but it’s NOT.

In fact, according to Brainscape’s How To Study Blog, "If you put in short bursts of hard work doing active recall (solving problems from scratch), you can save yourself hours and hours of wasted time sweating over useless material and rereading and rereading your textbook."

How do you do this? With flashcards.

Again, the Brainscape blog researchers say, "Active recall has been proven to create stronger neuron connections.” And because flashcards can so easily facilitate repetition, they are the best way to create multiple memory-enhancing recall events.

Flashcards utilize your metacognitive faculties. What is metacognition? Metacognition is simply thinking about one's thinking. When you look at the answer side of a flashcard to see if you got the answer right, you are essentially asking yourself “How did my answer compare to the correct answer?” or “How well did I know (or not know) it?”

Research shows that applying metacognition to your study process tends to burn those answers and memories deeper into your brain, ensuring you remember the right answer on tests and in practicing a new skill.

Flashcards allow for confidence-based repetition. Flashcards are essentially a deck of cards. They’re loose. They’re not in a book or on a page.

You can group them, separate them, shuffle them, or tuck a few in your pocket to use when you’ve got a few free minutes. This is what makes them so effective.

Decades of research have proven this practice of retrieval and repetition to be the most scientifically optimized way to improve memory performance.

Using online flashcards, or apps that allow you to convert your smartphone into a flashcard app is even better. Nothing comes close to flashcards for learning new information quickly and thoroughly. Find flashcard apps or aids on sites like MassageStudyBuddy.com, or create your own.

A mixture of pictures and words works best. Adding pictures to your flashcards can make the cards and the concepts or facts on them, a lot more memorable.

In cognitive psychology, there’s a concept called the “picture superiority effect,” which describes how people tend to remember imagery a lot better than they remember words. Blogger and researcher Thomas Frank offers the following flash card tips:

Use weird associations on your flashcards. “The weirder and wackier your associations are, the more easily you’ll remember them. That’s because your brain is adapted to remember things that are out of the ordinary.”

Use only one fact per card. Our brain learns through active recall—but to do that there must only be one fact per card.

Break complex questions into multiple cards. Remember, only one fact per card! Yes, you’ll need more cards, but you’re more likely to learn and remember each fact.

Read your flashcard out loud. You can ask a friend, or a schoolmate to read the card to you, or you can simply read the card out loud to yourself.

Frank isn’t the only one who loves flashcards.

According to California Coast EDU, "Flashcards are very good at helping you drill relationships between two pieces of information—but that’s it. That makes them good for learning definitions, vocabulary words, etc.—but it makes them a particularly bad study tool for information that fits into a larger visual or organizational hierarchy.

“Other ways to study are to take sample quizzes and tests. Either make them up yourself or use an online program that provides sample questions for you,” notes California Coast EDU.

Only Massage Study Buddy uses flashcards for all topics and areas in the MBLEx study guide, and best of all, the flashcard and question tools are free, as is the entire site.

While other sites may offer flashcard access, there is generally a $50 to $197 fee, and a limit on the time you have access to the cards.

Flashcards are a proven study tool for learning any new topic, language, skill, or area of study, and using them for free throughout your schooling will help prepare you for the MBLEx exam without adding to your financial costs for school.

D: Don’t cram for the exam. UCLA researchers say cramming and pulling an all-nighter before the MBLEx exam won’t help you retain information.

In fact, cramming and all-nighters have been shown to make students forget information they already knew!

UCLA professors report that “Sacrificing sleep for extra study time, whether it's cramming for a test or plowing through a pile of homework, is actually counterproductive.

"Regardless of how much a student generally studies each day, if that student sacrifices sleep time in order to study more than usual, he or she is likely to have more academic problems, not less, on the following day,” the professors say.

A consistent study schedule where you study for a short amount of time every day, rather than at the end of class, or before an exam, is the most effective study habit to form.

E: Get enough sleep every night. If you’re attending school, studying, and also holding down a job or family responsibilities you may find yourself becoming sleep deprived.

Unfortunately, sleep deprivation hurts your ability to learn. Get the sleep you need, especially in the days leading up to the MBLEx exam. You’ll feel better and do better.

Stay hydrated, get rest and tell yourself you will do well. Having confidence in yourself and what you know is a huge factor in doing well on the exam.

If you study the MBLEx study guide consistently and quiz yourself regularly, you will, no doubt, pass your first time.

About Massage Study Buddy

For over 30 years, MASSAGE Magazine’s mission has been to "provide future massage and touch therapists information, tools and resources to help them succeed in their careers and session rooms."

MASSAGE Magazine’s free study tool, Massage Study Buddy, is guaranteed to help massage therapy students pass the MBLEx the first time. Based on the proven studies and effectiveness of flashcards and adaptive learning, their website provides the easiest, most effective study tools currently on the market.

With 282 easy-to-use flash cards and over 1,400 MBLEx answers in the Massage Buddy study guide, you can prep with high-quality materials anytime, anywhere. Study when and where you want, anytime you want. The exam prep questions were created by massage industry educators, ensuring you study real questions with a real application for the MBLEx.

Massage Study Buddy guarantees you’ll pass on your first try, saving you money and time. This website will help get you working as quickly as possible after graduation. You can start studying immediately after signing up.

There’s no charge and no hidden costs.

While you’re there, download the free eBook about the 10 Things You Won’t Learn in Massage School, such as how to run your practice like a business.

Massage school will teach you how to do massage with skill and compassion, but the curriculum probably doesn’t include information about things like the latest business techniques or technology that will help you keep your clients scheduled and your records secure and easy to access.

No matter what hands-on specialty you choose, you'll need a strategy to reach your clients and potential clients. This eBook will give you the practical knowledge of how to get in front of clients to start a successful massage business, how to make money filing insurance claims and more.

Where Insurance is a Requirement of Being Licensed

Eight states now require liability insurance as a requirement of being a licensed, practicing massage therapist. Some massage and insurance experts claim that more and more states are expected to add liability insurance to their massage therapy licensing requirements, while others believe insurance will not become mandatory.

Whatever the states decide about liability, you should consider consider it for yourself if you’re serious about operating as a business person.

Insurance is more than another cost of doing business; it’s protection for you in case of an accident or an unforeseen event that could sink your entire practice in a moment if you’re not covered.

Even the most experienced, professional and careful massage therapists can make a mistake. Worse, even the best massage therapists can encounter a hard-to-please client who finds fault in a treatment, even if nothing really went wrong, and decides to file a complaint or sue.

Professional liability (malpractice liability) is required; however, it's a good idea to consider personal liability insurance as well, for claims such as slip and fall accidents, property damage coverage, and possible rental property coverage, in the event something happens to your business property.

The Best Massage Therapist Liability Insurance in the Industry

When it comes to liability insurance, you can’t do better than MASSAGE Magazine’s $25 rate for your first year.

Start your career right. Get the coverage you need to begin your professional career on the right foot. Don't worry about losing your business because of an insurance claim against you or your practice.

MASSAGE Magazine Insurance Plus offers an affordable liability insurance option to students pursuing careers in massage therapy or one of 350+ other health, wellness, and beauty disciplines.

MASSAGE Magazine Insurance Plus offers high insurance limits, and an industry preferred liability policy.

Learn more about the kind of insurance you need, and why you need it by reading our free insurance guide. Students must be enrolled as a student on the effective date of coverage to be eligible for either student program.

Rates reflect first-time pricing only. MASSAGE Magazine Insurance Plus’s student policies will only cover the discipline you are in school for on the day your coverage begins.

For the first-year rate of $25, students will receive the massage industry-preferred student insurance available, complete with all the benefits of our professional insurance program.

This policy covers students for 12 full months with $2 million of professional and general liability insurance, plus rental damage insurance.

Additional benefits include stolen equipment insurance, identity protection, a free professional website and a monthly newsletter.

To find an agent familiar with insuring massage therapists, Google massage therapist insurance, or visit MASSAGE Magazine’s Insurance guide.

The types of claims massage therapists can see include bodily injury, property damage, allergic reactions to oils, hot-stone burns and more. To have a strong base of coverage, massage therapy insurance should, at the very least, provide general liability, professional liability, products and completed operations.

MASSAGE Magazine Insurance Plus includes additional coverage such as identity theft and stolen equipment protection.

Although all massage therapists should carry insurance in order to protect their practices, massage therapists practicing in Alabama, Colorado, Indiana, Massachusetts, Missouri, Oklahoma, South Dakota and Wisconsin must carry insurance, as it is state law.

Professional Liability Insurance: This is malpractice insurance.

General Liability Insurance: Trip and fall insurance in the event a client, or yourself, trips and falls at your business.

Occurrence Form Insurance: Occurrence Form Insurance is the industry-preferred policy type over Claims Made, as the policy holder is covered for any incident that happened while the policy was in effect.


To ensure that you, the modalities you practice and your business are well protected, it’s a good idea to get the right kind of insurance and to buy it when you begin practicing on the public, even during your clinical rotation while in school.

MASSAGE Magazine Liability Insurance plans offer the best insurance for beginning and veteran therapists.

Keeping Your Credential Up to Date

States that license or certify massage therapists have dedicated regulatory divisions or boards where they post the necessary licensure requirements, including the need for continuing education you must have before they will license you.

Some states require annual renewal, others every other year, and some every three years.

Renewal postcards are typically sent out at least 90 days before the expiration date. So, make sure your state licensing board has your correct address.

Your expiration date should also appear on your current license, so put it in your calendar or make a note of it somewhere, so you don’t have to depend on the state to contact you. Most states require retesting and reapplying if your license expires.

Renew your massage therapy license as soon as possible after receiving your notice. Allow one to two weeks for receipt of your new license. Once you’re licensed you’ll also want to ensure you maintain your license by meeting any state needs for continuing education credits.

Locating the massage therapist license requirements on a state's regulating agency website can be difficult with the additional legislation and materials they also have on their website. Many state boards of massage therapy are under the umbrella of the department of health or medical licensure.

This can make it difficult to sort through and locate the massage therapist license requirements you are looking for, but don't give up. You can find them.

Your school should also have a list and website information for the license-renewal in your state.

If you need to take continuing education classes, check with your school, or with a other accredited state or national continuing education providers.

MASSAGE Magazine offers an affordable option for CE. They offer unlimited access to online CEs for the annual rate of $29.95, plus a link to each state to check the requirements for your area.

More Resources for Your New Massage Career

Knowing where to go, what to ask, how to decide what steps to take next in pursuing a massage therapy career can be intimidating.

MASSAGE Magazine is one helpful resource. The magazine publishes articles in print and online, covering technique, self-care, research, business and news about the massage industry. MASSAGE Magazine is the go-to source for new and veteran massage therapists.

You’re just as likely to read about a new massage technique as you are about marketing your business, or navigating the challenges of new laws. Here are just some of the articles you’ll find helpful as you start your new career:

Massage Therapy School, Everything You Need to Know

MASSAGE Magazine has put together this comprehensive guide to answer all your questions and to prepare you to begin massage therapy school.

Everything from “What is massage?” to “What will I study?” and “How much can I make?” is answered here.

17 Massage Software Products You Need to Know

There’s more to a massage practice than just massage. There’s marketing, billing, and more paperwork and files than you ever thought possible.

You need technology as well as great hands. As a massage therapist, you will use software to book and reschedule sessions, send emails and appointment reminders, follow up with clients, and a variety of tasks, including marketing yourself on social media.

These 17 apps can help you streamline your business so there’s more time to do what you love best—massage.

Build Trust With Your Massage Therapy Intake Form

Intake forms are a critical part of your practice. You need an intake form to rule out contraindications for the massage treatment, make your client aware of their rights and comply with HIPPA.

No matter what state you practice in, you'll need to keep records for each client. Learn more about intake forms and how to build trust in your clients with your intake form.

Laws and Legislation

“More than 46 states, the District of Columbia and four Canadian provinces currently offer some type of credential to professionals in the massage and bodywork field, usually licensure, certification or registration,” states MASSAGE Magazine.

Bookmark this page to make sure you’re complying with the latest laws. To view state licensing requirements click on a state or province on this site.

This is What the Highest Earning Massage Therapists Have in Common

Massage therapy is an important aspect of personal health care. If you're delivering this valuable service you should be adequately compensated for the time and value you provide.

Find out how to create a mindset of wealth, success, and healing and helping with the tips in this article.

Massage Insurance Resource Center

“MASSAGE Magazine Insurance Plus offers the industry-preferred occurrence form liability policy that protects you from claims that may arise after your policy expires,” states Massage Magazine Insurance Plus “Combined with our high insurance limits, our massage insurance gives you the peace of mind that you are protected against claims against you. Learn more about the kind of insurance you need and why you need it, here.”

Get Your Continuing Education Courses Online

MASSAGE Magazine’s Continuing Education Resource Center. This part of MASSAGE Magazine's website provides massage and bodywork therapists information about the variety of continuing education options they have, as well as factors to consider when choosing a continuing education product.

The Top 15 Massage Techniques You Can’t Afford to Miss

You didn't learn every massage technique there is to know in school. There are new and improved techniques being discovered all the time. This free eBook includes both new and established massage techniques.

Free eBooks for Massage Therapists on the Business of Massage:

Download any of MASSAGE Magazine’s free eBooks to learn more about a wide range of topics to help you build your massage practice, your social media following and more.

Now Get Going!

We hope this guide to how to become a massage therapist serves as a valuable resource as you find a school, determine the regulations you'll need to meet in your state and, importantly, begin studying to pass your exam and launch your exciting new career in massage.

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