Maryland Code

Maryland Code:

Subtitle 5A. Certification of Massage Therapists.

§ 3-5A-01. Definitions.

(a) In general.- In this subtitle the following words have the meanings indicated.

(b) Board.- "Board" means the State Board of Chiropractic Examiners.

(c) Certificate.- "Certificate" means, unless the context requires otherwise, a certificate issued by the Board to practice massage therapy.

(d) Certified massage therapist.- "Certified massage therapist" means an individual who is certified by the Board to practice massage therapy.

(e) Health care facility.- "Health care facility" has the meaning stated in § 19-114(d) of the Health - General Article.

(f) Massage Therapy Advisory Committee.- "Massage Therapy Advisory Committee" means the Committee established under § 3-5A-04 of this subtitle.

(g) Massage therapy.-

(1) "Massage therapy" means the use of manual techniques on soft tissues of the human body including effleurage (stroking), petrissage (kneading), tapotement (tapping), stretching, compression, vibration, and friction, with or without the aid of heat limited to hot packs and heating pads, cold water, or nonlegend topical applications, for the purpose of improving circulation, enhancing muscle relaxation, relieving muscular pain, reducing stress, or promoting health and well-being.

(2) "Massage therapy" does not include:

(i) The diagnosis or treatment of illness, disease, or injury;

(ii) The adjustment, manipulation, or mobilization of any of the articulations of the osseous structures of the body or spine; or

(iii) The laying on of hands, consisting of pressure or movement on a fully clothed individual, to specifically affect the electromagnetic energy or energetic field of the human body.

(3) In paragraph (2)(iii) of this subsection, "fully clothed" does not require the wearing of footwear.

(4) The provisions of paragraph (2) of this subsection do not preclude the application of the modalities described in paragraph (1) of this subsection to an individual who has an injury.

(h) Practice massage therapy.- "Practice massage therapy" means to engage professionally and for compensation in massage therapy.

(i) Practice non-therapeutic massage.- "Practice non-therapeutic massage" means to engage professionally and for compensation in massage therapy in a setting that is not a health care facility.

(j) Registration.- "Registration" means, unless the context requires otherwise, a registration issued by the Board to practice non-therapeutic massage.

(k) Registered massage practitioner.- "Registered massage practitioner" means an individual who is registered by the Board to practice non-therapeutic massage.

[1996, ch. 678; 1999, ch. 397; ch. 702, § 5; 2001, ch. 29, § 5; ch. 131.]

§ 3-5A-02. Board to adopt regulations.

The Board shall adopt regulations for the:

(1) Certification and practice of massage therapists; and

(2) Registration and practice of massage practitioners.

[1996, ch. 678; 1999, ch. 397.]

§ 3-5A-03. Fees.

(a) In general; funds to cover costs.-

(1) The Board shall set reasonable fees for the issuance and renewal of certificates and registrations and the other services it provides to massage therapists.

(2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the certification program, registration program, and the other services provided to massage therapists.

(b) Distribution of fees.-

(1) The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller of the State.

(2) The Comptroller shall distribute all fees to the State Board of Chiropractic Examiners Fund established under § 3-206 of this title.

(c) Use of fees.- The fees shall be used exclusively to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this subtitle.

[1996, ch. 678; 1999, ch. 397.]

§ 3-5A-04. Massage Therapy Advisory Committee.

(a) Established; composition.-

(1) There is a Massage Therapy Advisory Committee within the Board.

(2) The Committee shall consist of six members appointed by the Board.

(3) Of the six members:

(i) Two shall be licensed chiropractors; and

(ii) Four shall be certified massage therapists.

(b) Powers and duties.- In addition to the powers and duties set forth elsewhere in this subtitle, the Advisory Committee shall:

(1) Develop and recommend to the Board regulations to carry out the provisions of this subtitle;

(2) Develop and recommend to the Board a code of ethics for the practice of massage therapy for adoption by the Board;

(3) Develop and recommend to the Board the requirements for:

(i) Certification as a massage therapist; and

(ii) Registration as a massage practitioner;

(4) Evaluate the credentials of applicants and recommend to the Board certification of applicants who fulfill the requirements for:

(i) A certificate to practice massage therapy; or

(ii) A registration to practice non-therapeutic massage;

(5) Consider complaints brought to the Board involving certified massage therapists or registered massage practitioners and recommend to the Board the appropriate disciplinary action;

(6) Evaluate education programs in massage therapy for approval by the Board;

(7) Keep a record of its proceedings; and

(8) Submit an annual report to the Board.

[1996, ch. 678; 1999, ch. 397.]

§ 3-5A-05. Requirements for certification and registration.

(a) Persons permitted to practice massage therapy.-

(1) Except as otherwise provided in this subtitle, an individual shall be:

(i) Certified by the Board before the individual may practice massage therapy in this State; or

(ii) Registered by the Board before the individual may practice non-therapeutic massage in this State.

(2) This section does not apply to:

(i) A student enrolled in an approved education program as determined by the Board while practicing massage therapy in that program;

(ii) An individual permitted to practice massage therapy under regulations adopted by the Board, if the individual:

1. Otherwise has qualified to practice massage therapy in any other state or country that has substantially similar requirements for authorization to practice massage therapy and the individual is in this State for no more than 7 days; or

2. Has an application for a certificate pending before the Board but has not taken the examination required under this section or has taken an examination under this section, but the results of the examination are not yet known;

(iii) A family member practicing massage therapy on another family member;

(iv) An athletic trainer while functioning in the course of the athletic trainer's professional capacity;

(v) An individual employed by the federal government to practice massage therapy while practicing within the scope of the individual's employment; or

(vi) An individual working in a beauty salon:

1. For which the person who operates the beauty salon has obtained a permit from the State Board of Cosmetology as required under § 5-501 of the Business Occupations and Professions Article; and

2. In which the individual is providing cosmetology and esthetic services, including the application and removal of skin or skin care products.

(b) Qualifications for certification.- To qualify for a certificate, an applicant shall be an individual who:

(1) Is of good moral character;

(2) Is at least 18 years old;

(3) After January 1, 2002, has satisfactorily completed at least 60 credit hours of education at an institution of higher education as defined in § 10-101 of the Education Article and as approved by the Board and the Maryland Higher Education Commission;

(4) Has completed 500 hours of education in a Board approved program for the study of massage therapy that includes the following areas of content:

(i) Anatomy and physiology;

(ii) Massage theory, techniques, and practice;

(iii) Contraindications to massage therapy; and

(iv) Professional ethics; and

(5) Has passed an examination approved by the Board.

(1) Is of good moral character;

(2) Is at least 18 years old;

(3) Has completed 500 hours of education in a Board approved program for the study of massage therapy that includes the following areas of content:

(i) Anatomy and physiology;

(ii) Massage theory, techniques, and practice;

(iii) Contraindications to massage therapy; and

(iv) Professional ethics; and

(4) Has passed an examination approved by the Board.

(d) Waiver - In general.-

(1) Subject to the provisions of paragraph (2) of this subsection, the Board may waive any of the qualifications required for a certificate under this subtitle for an applicant who:

(i) Pays the application fee set by the Board;

(ii) Provides evidence acceptable to the Board that the applicant has practiced massage therapy for at least a total of 2 years after October 1, 1994 and before October 1, 1999 and has performed at least 300 paid massage therapy sessions; and

(iii) 1. Completes a Board approved program in the study of massage therapy; or

2. Passes an examination approved by the Board.

(2) The authority of the Board to grant a waiver under this subsection shall terminate on January 1, 2002.

(e) Same - Out-of-state applicants.-

(1) Subject to the provisions of this subsection, the Board may waive any requirement of this subtitle for an applicant who is registered, certified, or licensed to practice massage therapy in another state.

(2) The Board may grant a waiver under this subsection only if the applicant:

(i) Pays the application fee set by the Board; and

(ii) Provides adequate evidence that the applicant:

1. Has completed educational requirements that the Board determines to be equivalent to the Board approved educational requirements in this State;

2. At the time the applicant became certified, registered, or licensed in the other state, passed in that state or any other state an examination that the Board determines to be equivalent to the examination required in this State; and

3. Is of good moral character.

[1996, ch. 678; 1997, ch. 14, § 1; 1999, ch. 397; 2001, ch. 653.]

§ 3-5A-06. Non-therapeutic massage practitioners - Restrictions on practice.

An individual who is registered to practice non-therapeutic massage under § 3-5A-05 of this subtitle may not practice in a medical health care provider's office, hospital, or other health care facility for the purpose of providing massage.

[1999, ch. 397.]

§ 3-5A-07. Application.

(a) Certification requirements.- To apply for a certificate, an applicant shall:

(1) Submit to the Board an application on the form that the Board requires;

(2) Submit to the Board evidence of compliance with the requirements of § 3-5A-05 of this subtitle; and

(3) Pay the application fee set by the Board.

(b) Registration requirements.- To apply for registration, an applicant shall:

(1) Submit to the Board an application on the form that the Board requires;

(2) Submit to the Board evidence of compliance with the requirements of § 3-5A-05 of this subtitle; and

(3) Pay the application fee set by the Board.

[1996, ch. 678; 1999, ch. 397.]

§ 3-5A-08. Certification or registration expiration and renewal.

(a) In general.-

(1) A certificate or registration expires on the date set by the Board, unless the certificate or registration is renewed for a 1-year term as provided in this section.

(2) A certificate or registration may not be renewed for a term of longer than 2 years.

(b) Renewal notice.- At least 1 month before the certificate or registration expires, the Board shall send to the certificate holder or registration holder, by first class mail to the last known address of the certificate holder or registration holder, a renewal notice that states:

(1) The date on which the current certificate or registration expires;

(2) The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the certificate or registration expires; and

(3) The amount of the renewal fee.

(c) Renewal.- Before a certificate or registration expires, the certificate holder or registration holder periodically may renew it for an additional term, if the certificate holder or registration holder:

(1) Otherwise is entitled to be certified or registered;

(2) Submits to the Board a renewal application on the form that the Board requires; and

(3) Pays to the Board a renewal fee set by the Board.

(d) Name or address change; penalty.-

(1) Each certificate holder or registration holder shall notify the Board in writing of any change in the name or address of the certificate holder or registration holder within 60 days after the change occurred.

(2) If a certificate holder or registration holder fails to notify the Board within the time required under this subsection, subject to the hearing provisions of § 3-315 of this title, the Board may impose an administrative penalty of $100.

(e) Issuance of renewal.-

(1) The Board shall renew the certificate of each certificate holder who meets the requirements of this section.

(2) The Board shall renew the registration of each registration holder who meets the requirements of this section.

[1996, ch. 678; 1999, ch. 34, § 1; ch. 397.]

§ 3-5A-09. Denials; suspensions; revocations.

(a) Denial of certification or registration.- Subject to the hearing provisions of § 3-315 of this title, the Board may deny a certificate or registration to any applicant, reprimand any certificate holder or registration holder, place any certificate holder or registration holder on probation, or suspend or revoke the certificate of a certificate holder or the registration of a registration holder if the applicant, certificate holder, or registration holder:

(1) Fraudulently or deceptively obtains or attempts to obtain a certificate or registration for the applicant or for another;

(2) Fraudulently or deceptively uses a certificate or registration;

(3) Is disciplined by a licensing, certifying, or disciplinary authority of any other state or country or convicted or disciplined by a court of any state or country for an act that would be grounds for disciplinary action under this section;

(4) Is convicted of or pleads guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside;

(5) Willfully and knowingly:

(i) Files a false report or record of an individual under the care of the certificate holder or registration holder; or

(ii) Gives any false or misleading information about a material matter in an employment application;

(6) Knowingly does any act that has been determined by the Board, in its regulations, to exceed the scope of practice authorized to the individual under this subtitle;

(7) Provides professional services while:

(i) Under the influence of alcohol; or

(ii) Using any narcotic or controlled dangerous substance, as defined in § 5-101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication;

(8) Does an act that is inconsistent with generally accepted professional standards in the practice of massage therapy;

(9) Is negligent in the practice of massage therapy;

(10) Is professionally incompetent;

(11) Has violated any provision of this subtitle;

(12) Submits a false statement to collect a fee;

(13) Is physically or mentally incompetent;

(14) Knowingly fails to report suspected child abuse in violation of § 5-704 of the Family Law Article;

(15) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the certificate holder or registration holder is qualified to render because the individual is HIV positive;

(16) Except in an emergency life-threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control's guidelines on universal precautions;

(17) Is habitually intoxicated;

(18) Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5-101 of the Criminal Law Article;

(19) Fails to cooperate with a lawful investigation conducted by the Board;

(20) Engages in conduct that violates the professional code of ethics; or

(21) Knowingly does an act that has been determined by the Board to be a violation of the Board's regulations.

(b) Suspension or revocation of certification or registration; penalties in lieu.- If, after a hearing under § 3-315 of this title, the Board finds that there are grounds under subsection (a) of this section to suspend or revoke a certificate to practice massage therapy or registration to practice non-therapeutic massage, to reprimand a certificate holder or registration holder, or place a certificate holder or registration holder on probation, the Board may impose a penalty not exceeding $5,000 in lieu of or in addition to suspending or revoking the certificate or registration, reprimanding the certificate holder or registration holder, or placing the certificate holder or registration holder on probation.

(1) An individual whose certificate or registration has been suspended or revoked by the Board shall return the certificate or registration to the Board.

(2) If the suspended or revoked certificate or registration has been lost, the individual shall file with the Board a verified statement to that effect.

(d) Publication of revocations and suspensions.- The Board shall file a notice for publication in the earliest publication of the Maryland Register of each revocation or suspension of a certificate or registration under this section within 24 hours of the revocation or suspension.

[1996, ch. 678; 1999, ch. 397; 2002, ch. 213, § 6.]

§ 3-5A-10. Scope of subtitle.

This subtitle does not limit the right of an individual to practice or advertise an occupation that the individual is otherwise authorized to practice under the Maryland Annotated Code.

[1996, ch. 678; 1999, ch. 397.]

§ 3-5A-11. Prohibited actions.

(a) Practice without certification.- Except as otherwise provided in this subtitle, an individual may not practice, attempt to practice, or offer to practice massage therapy, massage, myotherapy, or any synonym or derivation of these terms in this State unless certified by the Board.

(b) Advertisting or misrepresentation.- An individual who is not certified as a certified massage therapist or registered as a massage practitioner under this subtitle may not advertise or claim by title, abbreviation, sign, card, or any other representation that the individual practices massage, massage therapy, myotherapy, or any synonym or derivation of these terms.

(c) Same - Restriction on therapeutic claims.- An individual who is a registered massage practitioner under this subtitle or a business entity that employs registered massage practitioners under this subtitle may not advertise to the public that the individual or business entity provides health-related therapeutic massage services.

(d) Practice in Charles and Washington counties.-

(1) In Charles County and Washington County, an individual may not perform a massage or offer to perform a massage on another person for compensation unless the individual who performs the massage or offers to perform a massage is a certified massage therapist or registered massage practitioner.

(2) A law enforcement officer in Charles County or Washington County may demand proof of certification or registration.

(e) Violations; penalty.- Any individual who violates a provision of this section is guilty of a misdemeanor and on conviction shall be subject to a fine not exceeding $5,000 or imprisonment for not more than 1 year, or both.

[1996, ch. 678; 1999, ch. 397; 2000, ch. 61, § 1; 2002, ch. 501; 2003, ch. 317.]

§ 3-5A-12. Referral restrictions.

A health care provider licensed or certified under this article may not refer patients to a person who is not a certified massage therapist.

[1999, ch. 397.]

§ 3-5A-13. Reimbursement by insurer not required.

Notwithstanding the fact that these services are provided within the scope of their certified practice, nothing in this subtitle requires a nonprofit health service plan, insurer, health maintenance organization, or person acting as a third party administrator to reimburse a certified massage therapist or registered massage practitioner for any services rendered.

[1996, ch. 678; 1999, ch. 397.]

§ 3-5A-14. Charles and Washington counties.

(a) In general.- In Charles County and Washington County, the County Commissioners may adopt ordinances or regulations relating to massage establishments and the practices of massage therapists, massage practitioners, and any other individuals who provide massage for compensation.

(b) Enforcement.-

(1) The Charles County Commissioners shall provide that the Director of the Charles County Health Department and the Office of the Sheriff for Charles County have the authority to carry out the provisions of the ordinances or regulations adopted under subsection (a) of this section.

(2) The Washington County Commissioners shall provide that the Washington County Health Officer and the Office of the Sheriff for Washington County have the authority to carry out the provisions of the ordinances or regulations adopted under subsection (a) of this section.

[2002, ch. 501; 2003, ch. 317; 2004, ch. 25.]