License vs. Certification for Massage Therapists: What's the Difference?

Updated June 30, 2023

Massage therapists are wellness professionals who apply pressure to the body to treat pain, soothe injuries, improve circulation, alleviate soreness and help clients relax and reduce stress. Becoming a massage therapist often involves training, education and specific credentials, like a license or certification. Whether required or optional, knowing more about the required designations to start or grow your career as a massage therapist can help you determine which path might be right for you.

In this article, we explore what a massage therapist license and certification are, the groups that provide them and explain the major differences between the credentials.

Key takeaways:

  • In most states, licensure is necessary to be a massage therapist while certification is an optional way to improve your credibility, with some states requiring this certification as well.

  • A massage therapist can pursue their license through the state they live in, while many certification programs are offered through nongovernment organizations and schools.

  • Massage therapist licenses and certifications may require candidates to pass exams, present proof of clinical hours and complete continuing education.

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What is a massage therapist license?

A massage therapist license is a professional distinction given to those who meet specific requirements to work with customers in places that require it. A license helps ensure a level of safety, standards and professionalism, especially because the job involves close contact. Licenses often get issued from the state you want to live and work in. Before getting licensed, you usually earn a diploma from accredited schools and programs, learning body mechanics, medical terminology, human anatomy, massage techniques and physiology.

Traditionally, becoming licensed and registered is mandatory to work as a massage therapist, as only a handful of states don't require it. To earn your state license to work as a massage therapist, you typically have to complete a certain number of training hours, which varies by state. Many states accept 500 hours of training or more, though, some require 1,000 training hours. Depending on the school or program you attend, you traditionally have courses of study mixed with practical experience, like an internship or school clinic, to help you earn the required hours toward licensing. Licensing also involves:

  • Passing a state-created exam, if applicable

  • Taking the 100-question Massage and Bodywork Licensing Exam (MBLex), run by the Federation of State Massage Therapy Boards

  • Completing an application and showing proof of requirements

  • Undergoing a background check

  • Paying a license and registration fee

Related: Learn About Being a Massage Therapist

What is a massage therapist certification?

A massage therapist certification is typically an additional and optional credential you can gain for this profession. In some states, it's required instead of a license. Certification can often help you request a higher salary, help distinguish you from other job candidates and may even help you attract more clients. While certification programs vary, you usually need a certain number of clinical hours before you can take the specific exam.

Consider earning specialty certifications if you want to work with specific types of massage or clientele. For example, you can train in sports massage to work with athletes. Here are other certifications and specialties you can pursue:

  • Palliative care massage

  • Clinical rehabilitative massage

  • Veterinary and equine massage

  • Spa management and massage

  • Oncology massage

  • Grief massage

Although there are various voluntary certifications you can earn as a massage therapist, only one main organization has national recognition—the National Certification Board for Therapeutic Massage and Bodywork ( NCBTMB). Within the industry, it's the highest professional designation you can earn. Earning a massage therapist board certification involves:

  • Getting a passing score on the NCBTMB board certification exam

  • Maintaining the NCBTMB's code of ethics and standards of practice

  • Undergoing a national background check

  • Verifying a current state-issued license

  • Graduating from a NCBTMB-approved school or getting board approval

  • Continuing education to meet renewal requirements

Related: How Much Do Massage Therapists Make? Salary Information by State and Career Info

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License vs. certification for massage therapists

There are several differences between a license and certification for massage therapists, though, each aims to protect both the public and the profession. Here are six differences to consider if you want to go into the massage therapy field:

Mandatory vs. voluntary work requirements

In many states and territories, being licensed and registered is more consistently required than being certified. Only four states have no regulations: Kansas, Minnesota, Vermont and Wyoming. Because each state oversees this profession, consider researching what individual requirements your state has compared to others. For example, some states also require licensed therapists to have liability insurance. In addition, state licenses only apply to a specific state, though, being certified usually transfers between states—especially if certification is optional where you want to practice.

Organizations issuing the credential

The organization issuing your credential is different if you're getting licensed or certified, too. Licenses get issued at the state level, whereas certifications are from non-governmental associations, schools, organizations or entities. Some groups that issue certifications have national recognition, meaning your credential typically gets accepted in whichever state or U.S. territory you want to practice. Consider thoroughly researching programs to ensure they have valid and widely accepted certifications to use throughout your career.

Related: Massage Therapist vs. Physical Therapist: What's the Difference?

Total number of tests

Another difference between a licensed or certified massage therapist is the total number of tests required to earn the credential. For example, becoming a state-licensed and registered massage therapist typically only involves one test with a passing score. If you don't pass the test on the first attempt, you can take it again. Some states may require you to take the test every few years, along with completing certain hours of continuing education to maintain your credentials.

To become certified, you might take several exams to gain specific specializations, like deep tissue, therapeutic or acupressure massage. You're not limited to the number of certifications you can take or earn throughout your career. As new massage methods and techniques develop, you might study them and prove your skills and abilities through a certification exam.

Industry titles

Industry titles often vary between licensed and certified massage therapists. However, depending on which credentials you have, you might hold several titles. Here are four acronyms used most often in the massage industry and what they mean:

  • Licensed massage therapist (LMT): An LMT has a state government license to practice within that state. Most states require licensing, and many have various issuing qualifications.

  • Registered massage therapist (RMT): An RMT also receives registration through their state, though, there may be fewer qualifications and requirements to earn an RMT designation versus an LMT.

  • Certified massage therapist (CMT): A CMT has earned a certification from a non-governmental organization. While not always required to practice, certifications hold value and offer plenty of benefits.

  • Certified massage practitioner (CMP): A CMP is usually certified to practice, though, they're still completing training hours. CMPs typically work toward becoming a CMT.

While titles may get used interchangeably, it's important to note that each has specific requirements and qualifications. Consider researching what's required in the state you want to practice in.

Legal ability to practice

In a licensed-operated state, the practice of massage therapy gets regulated. This means there are outlines as to what's considered a massage or not. Regulation helps protect clients from getting services from someone not fully qualified. For example, someone working at a spa may perform certain pressure techniques in their job duties, however, they may not have the ability to do more advanced massage methods, like hot stone or trigger point massage, unless they're licensed.

Conversely, in non-licensing states that only require certification, local municipalities can still implement regulations that might be less strict. This allows some practitioners to work without state certification. In states with these regulations, being a certified massage therapist can often give customers greater confidence.

Ongoing upkeep

The standards for the ongoing upkeep of your license and certifications vary, too. For example, state credentials usually require minimum hours of continuing education and renewal fees to maintain your registration and license. In comparison, many specialty certifications don't, though, it highly depends on the issuing organization. Some certifications issued by the NCBTMB demand annual practical hours and about 25 hours of educational learning to keep a certification valid and current. Consider reviewing specific certifications to know how to maintain them.

Please note that none of the companies mentioned in this article are affiliated with Indeed.

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