Alabama Administrative Code Chapter 532-X-3 — Massage Therapist Licensure

532 Massage Therapy Licensing Board, Alabama

Ala. Admin. Code r. 532-X-3-.01 Massage Therapist License Required

Unless otherwise exempt under the law, no individual may do any of the following in Alabama unless he or she is licensed as a massage therapist:

1. Advertise that he or she performs massage therapy or related touch therapy modalities.
2. Hold himself or herself out to the public as a massage therapist, using any name or description denoting himself or herself as a massage therapist, or purporting to have the skills necessary to perform massage therapy.
3. Practice massage therapy on the general public for compensation.

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §34-43A-6.
• New Rule: Filed January 29, 2001; effective March 5, 2001. Amended: Filed November 9, 2006; effective December 14, 2006. Amended: Filed April 20, 2009; effective May 25, 2009. Amended: Filed February 10, 2012; effective March 16, 2012. Amended: Published October 31, 2019; effective December 15, 2019. Amended: Published September 29, 2023; effective November 13, 2023. Repealed and New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.02 Exemptions

The following individuals, offices, and establishments are exempt from licensure:

1. A student who is rendering massage therapy services under the supervision of a massage therapy instructor. A student shall be designated by title clearly indicating his or her training status.

2. An individual practicing massage therapy pursuant to a temporary permit issued by the board.

3. A qualified member of another profession who is licensed and regulated under state law rendering services which are within the scope of his or her license, provided that the individual does not represent himself or herself as a massage therapist.

4. An individual providing massages to his or her immediate family.

5. An individual offering massage therapy instruction who is visiting from another state, territory, or country, provided that the individual is licensed or registered as required in his or her place of residence. A visiting instructor may teach continuing education courses in this state for up to 100 hours per year without being licensed by the board. A visiting instructor who teaches continuing education courses in this state for 100 hours or more per year is required to be licensed by the board.

6. Members of the Massage Emergency Rescue Team (MERT), or any other nationally or internationally recognized disaster relief association, who practice massage therapy in this state only during a time declared by the Governor or the Legislature to be a city, county, or state emergency. These therapists may work in this state for a period of time approved by the board.

7. A Native American healer using traditional healing practices. A Native American healer who applies to the board for a massage therapist license shall comply with all licensing requirements.

8. An individual acting under the supervision of and pursuant to delegation from a physician, a physical therapist, or a chiropractor for whom the delegated acts are within the scope of the license of the physician, physical therapist, or chiropractor, provided that the individual does not represent himself or herself as a massage therapist.

9. The office of a chiropractor, physician, or physical therapist which employs or contracts with a massage therapist to provide massage therapy at the physical location of the office is exempt from an establishment license.

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §34-43A-6.
• New Rule: Filed January 29, 2001; effective March 5, 2001. Repealed: Filed November 9, 2006; effective December 14, 2006. New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.03 Qualifications For Licensure As A Massage Therapist

(1) No individual may perform the duties of a massage therapist unless he or she holds a valid license issued by the board.

(2) To be licensed as a massage therapist, an individual shall:

(a) Have successfully completed a minimum of 650 hours of instruction from an education massage therapy school which shall consist of all of the following:

1. 1. 1. One hundred hours of anatomy and physiology, including 35 hours of myology, 15 hours of osteology, 10 hours of circulatory system, and 10 hours of nervous system, with the remaining 30 hours addressing other body systems at the discretion of the massage therapy school. 2. Two hundred fifty hours of basic massage therapy, the contradistinctions of massage therapy, and related touch therapy modalities, including a minimum of 50 hours of supervised massage. 3. Fifty hours of business, hydrotherapy, first aid, cardiopulmonary resuscitation, professional ethics, and state massage therapy laws. 4. Two hundred fifty hours of electives as determined by the massage therapy school.

(b) In the case of an applicant for licensure who holds or has held a valid massage therapist license in another state, if the education program did not meet the same educational criteria as Alabama programs, the applicant’s continuing education, work experience, or other factors relevant to qualification to practice massage therapy in the state may be considered, at the discretion of the Board.

(c) Successfully pass either the Massage and Bodywork Licensing Examination (MBLEx) or the Board Certification Examination for Therapeutic Massage and Bodywork (BCETMB). The board may approve other state exams on a case-by-case basis.

(d) Successfully complete a criminal history background check pursuant to Section 34-43A-13(c) of the Code of Ala. 1975.

(e) Pay all applicable fees.

(f) Provide proof of coverage demonstrating that the applicant possesses professional and general liability insurance with an “A” rated or better insurance carrier in the amount of at least one million dollars.

(g) Satisfy the requirements of Code of Ala. 1975, §31-13-7 related to citizenship or lawful presence.

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §34-43A-6.
• New Rule: Filed January 29, 2001; effective March 5, 2001. Amended: Filed April 20, 2009; effective May 25, 2009. Amended: Filed February 10, 2012; effective March 16, 2012. Amended: Published September 29, 2023; effective November 13, 2023. Repealed and New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.04 Application Process For Initial Licensure

(1) The applicant shall submit to the board:

(a) A completed application on a board-approved form.

(b) Required fees.

(c) Proof of coverage demonstrating that the applicant possesses professional and general liability insurance with an “A” rated or better insurance carrier in the amount of at least one million dollars.

(d) The fingerprint card and form (see Chapter 532-X-8)

(e) A completed Citizenship or Lawful Presence Checklist and supporting documentation.

(2) A primary source official school transcript shall be submitted to the board and shall indicate the date of the applicant’s completion of the program and/or the date the degree/certificate was conferred.

(a) Applicants may be required to submit additional evidence satisfactory to the board that they have completed the course content and hours of instruction required for licensure in Alabama pursuant to Code of Alabama 34-43A-8(a)(1) and Alabama Massage Therapy Licensing Board Rule 532-X-3-.03.

(3) Primary source verification shall be submitted of the applicant having successfully passed either the Massage and Bodywork Licensing Examination (MBLEx) or the Board Certification Examination for Therapeutic Massage and Bodywork (BCETMB).

(4) The applicant may be subject to an initial in-person board hearing, as determined by the board.

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §34-43A-6.
• New Rule: Filed January 29, 2001; effective March 5, 2001. Amended: Filed November 9, 2006; effective December 14, 2006. Amended: Filed April 20, 2009; effective May 25, 2009. Amended: Filed February 10, 2012; effective March 16, 2012. Amended: Published October 31, 2019; effective December 15, 2019. Amended: Published August 31, 2022; effective October 15, 2022. Amended: Published September 29, 2023; effective November 13, 2023. Repealed and New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.05 Application Process For Massage Therapist Initial Licensure By Endorsement From Another Jurisdiction

(1) The applicant shall submit to the board:

(a) A completed application on a board-approved form.

(b) Required fees.

(c) Proof of coverage demonstrating that the applicant possesses professional and general liability insurance with an “A” rated or better insurance carrier in the amount of at least one million dollars.

(d) The fingerprint card and form (see Chapter 532-X-8)

(e) A completed Citizenship or Lawful Presence Checklist and supporting documentation.

(2) Primary source verification of licensure in another state in the United States, together with proof that at the time of the applicant’s original licensure in the other state of licensure, the requirements for the applicant to obtain that license were equal to or stricter than those qualifications for licensure described in these rules.

(3) A primary source official school transcript shall be submitted to the board and shall indicate the date of the applicant’s completion of the program and/or the date the degree/certificate was conferred.

(a) Applicants may be required to submit additional evidence satisfactory to the board that they have completed the course content and hours of instruction required for licensure in Alabama pursuant to Code of Alabama 34-43A-8(a)(1) and Alabama Massage Therapy Licensing Board Rule 532-X-3-.03.

(4) The applicant may be subject to an initial in-person board hearing, as determined by the board.

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §§34-43A-6, 34-43A-7.
• New Rule: Filed January 29, 2001; effective March 5, 2001. Amended: Filed November 1, 2005; effective December 6, 2005. Amended: Filed November 9, 2006; effective December 14, 2006. Amended: Filed April 20, 2009; effective May 25, 2009. Amended: Filed February 10, 2012; effective March 16, 2012. Amended: Published September 29, 2023. effective November 13, 2023. Repealed and New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.06 Massage Therapist License Renewal

1. Each massage therapist license shall be renewed biennially, on or before the anniversary date of the license. 1. Any applicant for renewal who has not previously completed a fingerprint background check pursuant to Alabama Act 2024-361 shall be required to submit to such a fingerprint background check for the first licensure renewal occurring after June 1, 2024.

2. Any massage therapist license not renewed biennially on or before the anniversary date shall expire.

3. The applicant shall submit to the board:

4. 1. A completed application on a board-approved form. 2. Required fees. 3. The fingerprint card and form, if applicable. [see Chapter 532-X-8 and Section 532-X-3-.06(1)(a)] 4. Proof of coverage demonstrating that the applicant possesses professional and general liability insurance with an “A” rated or better insurance carrier in the amount of at least one million dollars. (d) The fingerprint card and form (see Chapter 532-X-8) 5. If the applicant’s United States citizenship has not previously been established pursuant to the requirements of Code of Ala. 1975, §31-13-7, a completed Citizenship or Lawful Presence Checklist and supporting documentation. 6. Evidence of satisfactory completion of sixteen hours of continuing education which meets the requirements of Chapter 532-X-6.

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §34-43A-6.
• New Rule: Filed January 29, 2001; effective March 5, 2001. Amended: Filed April 20, 2009; effective May 25, 2009. Amended: Filed February 10, 2012; effective March 16, 2012. Amended: Published October 31, 2019; effective December 15, 2019. Amended: Published August 31, 2022; effective October 15, 2022; operative January 1, 2023. Amended: Published September 29, 2023; effective November 13, 2023. Repealed and New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.07 Massage Therapist Reinstatement Of Expired License

1. An individual whose massage therapist license has expired and who has ceased to practice massage therapy for a period of no more than five years may apply to reinstate the massage therapist license.

2. To apply to reinstate an expired license, the applicant shall submit:

3. 1. 1. A completed application on a board-approved form. 2. A reactivation fee and all other required fees. 3. The fingerprint card and form (see Chapter 532-X-8) 4. Proof of coverage demonstrating that the applicant possesses professional and general liability insurance with an “A” rated or better insurance carrier in the amount of at least one million dollars. (d) The fingerprint card and form (see Chapter 532-X-8) 5. If the applicant’s United States citizenship has not previously been established pursuant to the requirements of Code of Ala. 1975, §31-13-7, a completed Citizenship or Lawful Presence Checklist and supporting documentation. 6. Evidence of satisfactory completion of sixteen hours of continuing education which meets the requirements of Chapter 532-X-6. 7. Primary source verification of having successfully passed either the Massage and Bodywork Licensing Examination (MBLEx) or the Board Certification Examination for Therapeutic Massage and Bodywork (BCETMB).

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §34-43A-6.
• New Rule: Filed May 19, 2004; effective June 23, 2004. Repealed and New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.08 Temporary Permit For Supervised Practice

1. A first-time applicant for an Alabama massage therapist license may apply for a temporary permit for supervised practice.

2. A temporary permit for supervised practice may be issued by board staff only when all of the following requirements are met:

3. 1. 1. The applicant for a temporary permit has submitted a complete application for initial licensure as a massage therapist. 2. The applicant’s application and supporting materials do not reveal any grounds for denial of a massage therapist license.

4. Practice under a Temporary Permit for Supervised Practice is limited as follows:

5. 1. 1. The application for a temporary permit must identify the name and license number of the licensed massage therapy establishment at which the supervised practice will occur and the name, license number and signature of the licensed massage therapist who agrees to provide onsite supervision to the temporary permit holder. 2. The holder of the temporary permit may practice only at the identified licensed massage therapy establishment and may practice only when the identified supervising licensed massage therapist is present at the licensed massage therapy establishment.

6. A Temporary Permit for Supervised Practice expires on the earliest of:

7. 1. 1. 120 days 2. Licensure as a massage therapist in Alabama 3. Denial of a massage therapist license

8. An individual may receive only one Temporary Permit for Supervised Practice per lifetime.

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §34-43A-4.
• New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.09 Licensed Massage Therapist Registration To Licensed Massage Therapy Establishment (Repealed)

(Repealed)

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §§34-43A-6, 34-43A-4(a)(1).
• New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published March 31, 2025; effective May 15, 2025. Repealed: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.10 Special Circumstances

1. Any applicant for initial licensure who possesses an active, unencumbered license in another state and who is the eligible spouse of a service member or other qualified individual, as defined in Section 31-1-6, Code of Ala. 1975, shall:

2. 1. 1. Be eligible to apply for a service member spouse temporary permit, which shall be valid for 365 days. 2. Be exempt from payment of the initial licensure fee provided for in Section 532-X-1-.11 of these rules. 3. Substantiate his or her eligibility by providing the following:
3. 1. 1. 1. A marriage certificate substantiating marriage to the service member. 2. Official documentation of the qualified service member or other qualified individual’s relocation to the state.

4. When a licensed massage therapist who is actively serving in the military is deployed at the time of their biennial renewal, the license shall not lapse, provided that the following conditions are met:

5. 1. 1. The license was active at the time of deployment. 2. The licensee provides the Board a copy of the military activation or deployment orders, or other proof of active military service, in advance of deployment. 3. The licensee renews the license no later than December 31 of the next year following return from deployment.

6. In the event that a licensed massage therapist who is actively serving in the military and deployed at the time of their biennial renewal fails to notify the Board prior to deployment, the license shall lapse, if not renewed. However, the license may be reinstated or renewed without penalty or payment of the reinstatement or late renewal fee(s) under the following conditions:

7. 1. 1. The license was active at the time of deployment. 2. The application for reinstatement or renewal is made while still in the armed services or no later than six months after discharge from active service or return to inactive military status. 3. A copy of the military activation orders or other proof of active military service accompanies the application. 4. (d) The renewal fee is paid. 5. If the required continuing education contact hours were not earned for renewal during the earning period, the licensed massage therapist shall be required to complete the required continuing education hours needed for renewal no later than six months after discharge from active service, return to inactive military status, or return from deployment.

8. The continuing education contact hours used to renew the license under paragraphs (2) or (3) may not be used for the next license renewal.

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §34-43A-6.
• New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.11 Code Of Ethics For Licensed Massage Therapists

The licensed massage therapist shall comply with the following code of ethics. Violations of the code of ethics may result in disciplinary action:

1. The licensee must comply with all legal requirements in applicable jurisdictions. The licensee shall: 1. obey all local, state, and federal laws. 2. refrain from any behavior that results in illegal, discriminatory, or unethical actions. 3. accept responsibility for the licensee's own actions. 4. upon reasonable belief that another massage therapist has violated Chapter 43A of Title 34 of the Code of Ala. 1975, and any amendments thereto, or the Alabama Massage Therapy Licensing Board Administrative Code, inform the Alabama Massage Therapy Licensing Board within thirty (30) calendar days after the date the licensee discovers the activity. 5. maintain accurate and truthful records. 6. comply with Chapter 43A of Title 34 of the Code of Ala. 1975, and any amendments thereto, and the Alabama Massage Therapy Licensing Board Administrative Code. 7. perform only those services which are within the scope of practice of a licensed massage therapist in Alabama and for which the licensed massage therapist is qualified through education, certifications, and professional affiliations. 8. Accurately inform clients, the public, and other healthcare providers of the scope and limitations of the licensee’s discipline.

2. In the licensee's professional role, the licensee shall: 1. Treat each client with respect, dignity, and worth. 2. Use professional verbal, nonverbal, and written communications. 3. Provide an environment that is safe and comfortable for the client and which, at a minimum, meets all legal requirements for health and safety. 4. Use standard precautions to ensure professional hygienic practices and maintain a level of personal hygiene appropriate for practitioners in the therapeutic setting. 5. Wear clothing that is clean and professional. 6. Obtain voluntary and informed consent from the client prior to initiating the session. 7. If applicable, conduct an accurate needs assessment, develop a plan of care with the client, and update the plan as needed. 8. Use appropriate draping to protect the client's physical and emotional privacy.

3. The massage therapist shall utilize clean drape material (towel, sheet, blanket, linen) for draping clients during the massage, use of which shall be explained to the client prior to the massage, and which shall cover the intergluteal cleft and genitals of a male client at all times during the massage, and which shall cover the intergluteal cleft, breasts, and genitals of a female client at all times during the massage.

i. The massage therapist shall not intentionally expose the intergluteal cleft and genitals of a male/ female client or breasts of a female client.

ii. The massage therapist shall not inappropriately touch the mouth or genitals of a male/female client or breasts of a female client.

i. Acknowledge the limitations and contraindications of massage therapy, referring to other state licensed healthcare providers when deemed appropriate.

j. Seek other professional advice when needed.

k. Respect the traditions and practices of other professionals and foster collegial relationships.

l. Maintain professional boundaries with clients.

1. 1. 1. The licensed massage therapist shall adhere to ethical boundaries and perform the professional roles designed to protect both the client and the practitioner, and safeguard the therapeutic value of the relationship. 2. The licensed massage therapist must recognize the licensee's influential position with the client and not exploit the relationship for personal or other gain; 3. Recognize and limit the impact of transference and counter-transference between the client and the licensee; 4. Avoid dual or multidimensional relationships that could impair professional judgment or result in exploitation of a client, student, employee, supervisee, mentee, trainee, or anyone else with whom a power differential exists;

2. Refrain from practicing under the influence of alcohol, drugs, or any illegal substance.

3. Ensure that every appointment for massage therapy services is recorded in an appointment book (whether paper or electronic) which is available at the massage therapy establishment to which the licensed massage therapist is registered and through which the service will be performed. 1. Appointments shall be documented prior to commencement of the massage therapy services. 2. There shall be no undocumented massage therapy appointments. 3. Documentation of appointments shall be maintained on the premises of the licensed massage therapy establishment and available for inspection. 4. Documentation shall include the name of the client(s) who will receive massage therapy services at the appointment, the name of the licensed massage therapist(s) performing the massage therapy services, the location at which the massage therapy services will occur, the type and duration of the massage therapy services to be performed, and the date and time at which the massage therapy services will occur.

4. Respect state licensed healthcare providers whose intent is to promote the health and healing of their clients.

5. Conduct their business and professional activities with integrity.

6. Refuse to unjustly discriminate against clients or other state licensed healthcare professionals, respecting the inherent worth of all persons.

7. Acknowledge the confidentiality of all client information, respecting each client’s right to privacy, unless disclosure is required by law, court order, written release to third parties by the client, or in the event it is objectively necessary to protect the public.

8. Refrain from engaging in any sexual conduct, behavior, or activities involving a client, even if the client attempts to sexualize the relationship.

9. Respect the client’s right to refuse, modify, or terminate treatment.

10. Have the right to refuse treatment to any person for reasonable and just cause.

11. Provide treatment in an environment that ensures the comfort and privacy of the client.

12. Respect the client’s autonomy with regard to privacy, disclosure, beliefs, and emotional expression.

13. Through continuing education, maintain and improve professional knowledge and competency.

14. Adhere to and follow all policies, procedures, rules, regulations, codes, and requirements promulgated by Alabama laws regarding the practice of massage therapy, Act No. 2024-361, and amendments thereto.

15. The licensee shall respect the client’s dignity and right to privacy. The licensee shall:

16. 1. 1. Protect the confidentiality of the client's identity and information in all conversations, advertisements, and any and all other matters unless disclosure of identifiable information is requested by the client in writing, is medically necessary, or is required by law.
17. 1. 1. Protect the interests of clients who are minors or clients who are unable to give voluntary and informed consent by obtaining prior written permission from a legal guardian; 2. Solicit only information that is relevant to the professional client/therapist relationship; 3. Securely retain client files for a minimum period of four years from the termination of the therapeutic relationship; and 4. Dispose of client files in a secure manner.

18. The licensee shall practice with honesty, integrity, and lawfulness. The licensee shall:

19. 1. 1. Provide a physical setting that is safe and meets all applicable legal requirements for health and safety. 2. Maintain adequate progress notes for each client session, if applicable. 3. Accurately and truthfully inform the public of services provided. 4. Honestly represent all professional qualifications and affiliations. 5. Include the license number of the licensee or establishment on any advertisements.

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §34-43A-6.
• New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 532-X-3-.12 Prohibited Activities

1. A massage therapist may not administer, dispense, or prescribe drugs, or engage in the practice of medicine in any manner including, but not limited to, nutrition, diagnosing or prescribing drugs for mental, emotional, or physical disease, illness, or injury.
2. A massage therapist may not advertise or offer to perform services on any sexually explicit website or online platform that promotes prostitution, sexually explicit services, or human trafficking.
3. A massage therapist may not perform massage therapy for a sexually oriented business, shall be subject to all sections of Article 3 of Chapter 12 of Title 13A, Code of Ala. 1975.
4. A massage therapist may not advertise or offer to perform services outside the scope of his or her expertise, and education for any client who is ill or has a physical dysfunction, unless the services are performed in conjunction with a licensed physician, physical therapist, or chiropractor.
5. A massage therapist or massage therapy establishment may not advertise or offer to perform services on any sexually explicit website or online platform that promotes prostitution, sexually explicit services, or human trafficking.
6. A massage therapist may not perform therapeutic massage on an animal unless the massage therapist has graduated from a nationally approved program and completed at least 100 hours of postgraduate training and education in animal anatomy, pathology, and physiology for the specific type of animal upon which he or she will perform therapeutic massage. A massage therapist shall not commence performing therapeutic massage on an animal until the massage therapist has filed with the board documentation of the education and training required for therapeutic massage on the specific type of animal.

History

• Author: Alabama Massage Therapy Licensing Board
• Authority: Code of Ala. 1975, §34-43A-6.
• New Rule: Published September 30, 2024; effective November 14, 2024. Amended: Published September 30, 2025; effective November 14, 2025.