Frequently Asked Questions
Updated Massachusetts Massage Therapy Regulations
269 CMR 2.00 et. seq.
November 2025
What are the key changes to the massage therapy regulations? The Massachusetts Board of Registration for Massage Therapy, working with stakeholders, has been developing updates to 269 CMR 2.00 et. seq. for over five years. After numerous listening sessions, drafts and redrafts of the regulations and a mandated public hearing process, the Board promulgated wide range of updates to the regulations primarily concerning: continuing education, written documentation, informed consent, exam requirements for new applicants and compliance. While these are the major areas of updates, smaller updates – meant to provide administrative relief, accountability and transparency - are included throughout the regulations. Please review the newly amended regulations here.
Continuing Education
What is the new continuing education requirement?
Under the original passage of Mass. Gen. Laws, ch, 112, §229(c) in 2006, massage therapists are required to complete a certain amount of continuing education in order for their license to be renewed. The continuing education, while required, was never implemented until now. The new regulations require three continuing education hours every 12 months. The course content “shall exceed a basic level of knowledge as it relates to the “ethical obligations of massage therapy practitioners or laws and issues pertaining to human trafficking, specific to massage therapy practitioners”. (269 CMR 4.01(2)).
What does the “ethical obligations of massage therapy practitioners” mean?
The AMTA-MA has asked the Board to further define what this phrase entails. We will have more information about this phrase in the near future as the state Board will address the same at its January 2026 meeting. Throughout the regulatory process, the AMTA-MA urged the Board to take an expansive view of this clause, allowing for continuing education courses that blend ethical considerations throughout the underlying course of study.
When will the continuing education requirements be enforced?
At the November 2025 state board meeting, it was announced that the continuing education requirement would begin to be enforced for licensees renewing their license on or after June 1, 2026. This conforms to the agency’s standard six (6) month grace period.
Who can I get continuing education from?
The new regulations are quite expansive as it relates to accepted continuing education providers. Under 269 CMR 4.03(2), continuing education courses offered from the following organizations will be automatically accepted if they meet the requirement of teaching ethical obligations of massage therapy practitioners or laws and issues pertaining to human trafficking, specific to massage therapy practitioners: (a) American Massage Therapy Association; (b) Associated Bodywork and Massage Professionals; (c) National Certification Board for Therapeutic Massage & Bodywork; (d) Federation of State Massage Therapy Boards; (e) Alliance for Massage Therapy Education; (f) a Licensed Massachusetts Massage School pursuant to 269 CMR 4.00 and interpretive policies; or (i) any other nationally recognized provider of continuing education, determined to be acceptable to the Board. The continuing education can either be online or in-person. (Note: The AMTA website contains a variety of no cost and low-cost options.). The new regulations also provide a process for other entities to have their coursework approved.
Documentation
What has changed with respect to written documentation?
Under the previous regulations, no written documentation was required for “general relaxation” massage. Under the updated regulations, a “massage therapist who provides a massage for the purpose of general relaxation shall document, at a minimum, their own name, the name of the client, the date and time of the session, any contraindications, and the client’s Informed Consent for treatment.”. 269 CMR 5.03(3). This commonsense best management practice has been shown to protect licensees and their clients. All other types of massage already required written documentation as prescribed by the regulations.
How long do I have to retain written documentation?
The regulations, 269 CMR 6.06, require that records shall be maintained for seven years from the date of the last client encounter, unless the client is a minor at the time of services. If a client is a minor on the date of the last visit, then the records must be maintained for a minimum period of either seven years from the date of the last client encounter or until the client reaches the age of eighteen, whichever is the longer retention period. Written documentation may be kept electronically.
Informed Consent
What has changed relative to informed consent?
Under the amended regulations, a massage therapist must receive a client’s informed consent for treatment and any refusal, modification, or termination of treatment regardless of prior consent. The definition of “Informed Consent” has been amended to reflect “oral and written consent voluntarily given by a person who demonstrates a clear appreciation and understanding of the facts, procedures, implications, and future consequences of an action or procedure”. (269 CMR 2.01 & 269 CMR 5.01(4)).
Do I have to obtain a client’s written acknowledgement each time I see them?
Yes. This provision protects both massage therapists and clients so that everyone has a clear understanding and acknowledgement of the massage services to be provided.
Examination Requirement for New Applicants
Is there a new test requirement for new applicants?
Yes. The regulations require passage of a board-approved national examination for new applicants for a massage therapy license. The Board will likely select passage of the MBLEx as the required examination. Please note that this requirement only applies for applications submitted after January 1, 2027. (269 CMR 3.01(2)(I)).
Does the new test requirement apply to existing massage therapists?
No. This requirement does not apply to existing licensees now or when applying to renew an existing massage therapist’s license.
Establishment Related
Compliance Officers. What are the changes related to establishments pertaining to compliance officers?
The regulations now clearly explain that an establishment license holder must notify the Board within 10 days when there is a change in the compliance officer. (269 CMR 6.07(9).
Compliance Plans. What are the changes to a compliance plan to be aware of?
The amended regulations now require that the compliance plan include a list of all Massage Therapists who currently practice or have practiced at the Establishment and a list of all current and past employees of the Establishment with start and end dates for the past seven years. As well, the compliance plan must include a signature, and initials log to assist in identifying signature and and/or initials in records. The log shall include the employee's printed name, signature and their initials. (269 CMR 6.07(2)(b)&(c)).
Draping. Do the newly amended regulations address coverings and draping?
Yes, the regulations clearly spell out that a massage therapist must provide coverings with material that cannot be seen through (i.e. not transparent). In addition, according to professional standards of practice, draping is not optional. (269 CMR 2.01 & 269 CMR 6.07(5)(b)).
Other
Where can I find the newly amended regulations?
You may find a copy of the Massachusetts massage therapy regulations by clicking here.
How long have these regulations been in development?
The newly amended regulations have been in development for over five (5) years. The Board, as well as stakeholder organizations like the AMTA-MA, have been discussing these changes throughout. The Board conducted, and the AMTA-MA participated in, numerous public meetings, listening sessions and formal public hearings relative to these amendments. The AMTA-MA also provided numerous updates – online and in-person at meeting - on this issue repeatedly over the years.
Where can I send questions about the regulations?
The AMTA-MA encourages you to submit questions to the Massachusetts Board of Registration for Massage Therapy at Massagetherapy@mass.gov. Please share your questions with the AMTA-MA Chapter Government Committee Chair Greg Hurd, greghurdlmt@gmail.com, as well so that we can assist you in getting your question answered.