Except as otherwise provided in this title or §§ 10–14A–03 and 10–14B–03 of the State Government Article, before an individual may practice massage therapy in the State, the individual shall be: Licensed by the Board; or Registered by the Board to practice massage therapy in a setting that is not a health care setting. This section does not apply to: A student enrolled in an approved education program as determined by the Board while practicing massage therapy in the State; An individual permitted to practice massage therapy under regulations adopted by the Board, if the individual 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 the State for no more than 7 days; A family member practicing massage therapy on another family member; An athletic trainer while functioning in the course of the athletic trainer’s professional capacity; An individual employed by the federal government to practice massage therapy while practicing within the scope of the individual’s employment; or An individual working in a beauty salon: 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 In which the individual is providing cosmetology and esthetic services, including the application and removal of skin or skin care products.

In this section, “contact hour” means 50 minutes of actual instructional time per each 60–minute hour. To qualify for a license, an applicant shall be an individual who: Is of good moral character; Is at least 18 years old; Except as provided in subsection (c) of this section, has graduated from an institution of postsecondary education, as defined in § 10–101 of the Education Article and approved by the Maryland Higher Education Commission, with at least 750 contact hours of education in a curriculum: Approved by the Board; Endorsed by: The Commission on Massage Therapy Accreditation; or An equivalent entity that accredits both institutions of higher education and programs offering instruction in massage therapy; and Accredited by an institutional accreditation agency recognized by: The United States Department of Education; or Another entity that accredits programs offering instruction in massage therapy; Except as provided in subsection (c) of this section, has completed 750 contact hours of education in a Board–approved program for the study of massage therapy that includes the following areas of content: Anatomy, physiology, and kinesiology; Massage therapy theory; Contraindications and pathology; Professional ethics; Health and hygiene; Research; Supervised hands–on techniques; and Clinical assessment and documentation; Has passed an examination approved by the Board; and Submits to a criminal history records check in accordance with § 6–303 of this subtitle. An applicant who has graduated from an out–of–state program for the study of massage therapy shall have graduated from a program for the study of massage therapy that: Has been approved by the state’s higher education commission or similar entity that regulates institutions of postsecondary education; Has been endorsed by: The Commission on Massage Therapy Accreditation; or An equivalent entity that is an accrediting agency or organization that accredits both institutions of higher education and programs offering instruction in massage therapy; Is accredited by an institutional accreditation agency recognized by: The United States Department of Education; or Another entity that accredits programs offering instruction in massage therapy; and Subject to paragraph (2) of this subsection, requires at least 750 contact hours that includes the areas of content required under subsection (b)(4) of this section. An applicant who has graduated from an out–of–state program for the study of massage therapy that does not meet the contact hour requirement under this subsection may supplement the required hours with: Contact hours from a Board–approved program of study of massage therapy, on a 1–hour to 1–hour basis; Board–approved continuing education hours, on a 1–hour to 1–hour basis; or Documented evidence of having completed at least 1,000 licensed, out–of–state hours of hands–on massage therapy experience within the immediately preceding 2 years. Subject to paragraph (2) of this subsection, the Board may waive any requirement of this subtitle for an applicant who is licensed, certified, or registered to practice massage therapy in another state. The Board may grant a waiver under paragraph (1) of this subsection only if the applicant: Pays the application fee set by the Board; and Provides adequate evidence that the applicant: Has completed educational requirements that the Board determines to be equivalent to the Board–approved educational requirements in this State; At the time the applicant became licensed, certified, or registered 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 Is of good moral character. On or after October 1, 2024, the Board may not issue an initial registration to practice as a registered massage practitioner. The Board shall convert the registration of an individual registered by the Board as a registered massage practitioner to a license to practice massage therapy if the individual complies with regulations adopted by the Board.

In this section, “Central Repository” means the Criminal Justice Information System Central Repository of the Department of Public Safety and Correctional Services. As part of an application to the Central Repository for a State and national criminal history records check, an applicant shall submit to the Central Repository: One complete set of legible fingerprints taken on a form approved by the Director of the Central Repository and the Director of the Federal Bureau of Investigation; The fee authorized under § 10–221(b)(7) of the Criminal Procedure Article for access to State criminal history records; and The processing fee required by the Federal Bureau of Investigation for a national criminal history records check. In accordance with §§ 10–201 through 10–228 of the Criminal Procedure Article, the Central Repository shall forward to the Board and to the applicant the criminal history record information of the applicant. If criminal history record information is reported to the Central Repository after the date of the initial criminal history records check, the Central Repository shall provide to the Board a revised printed statement of the individual’s State criminal history record. If an applicant has made three or more unsuccessful attempts at securing legible fingerprints, the Board may accept an alternate method of a criminal history records check as permitted by the Director of the Central Repository and the Director of the Federal Bureau of Investigation. Information obtained from the Central Repository under this section: Is confidential and may not be redisseminated; and May be used only for the licensing or registration purpose authorized by this title. The subject of a criminal history records check under this section may contest the contents of the printed statement issued by the Central Repository as provided in § 10–223 of the Criminal Procedure Article. In using information obtained from the Central Repository under this section to determine whether to issue a license or registration, the Board shall consider: The age at which the crime was committed; The nature of the crime; The circumstances surrounding the crime; The length of time that has passed since the crime was committed; Subsequent work history; Employment and character references; and Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

To apply for a license or registration, an applicant shall: Submit to the Board an application on the form that the Board requires; Submit to the Board evidence of compliance with the requirements of § 6–302 of this subtitle; and Pay the application fee set by the Board. The Board shall issue a license or registration to any applicant who: Pays a license or registration fee set by the Board; and Meets the requirements of this subtitle. The Board shall include on each license and registration that the Board issues the kind of license or registration. On receipt of the criminal history record information of an applicant for licensure or registration forwarded to the Board in accordance with § 6–303 of this subtitle, in determining whether to grant a license or registration, the Board shall consider: The age at which the crime was committed; The circumstances surrounding the crime; The length of time that has passed since the crime; Subsequent work history; Employment and character references; and Any other evidence that demonstrates whether the applicant poses a threat to the public health or safety. The Board may not issue a license or registration if the criminal history record information required under § 6–303 of this subtitle has not been received.

A license or registration expires on the date set by the Board, unless the license or registration is renewed for a 1–year term as provided in this section. A license or registration may not be renewed for a term of longer than 2 years. At least 1 month before the license or registration expires, the Board shall send to the licensed massage therapist or registered massage practitioner, by electronic means or first–class mail to the last known electronic or physical address of the licensed massage therapist or registered massage practitioner, a renewal notice that states: The date on which the current license or registration expires; The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license or registration expires; and The amount of the renewal fee. Before a license or registration expires, the licensed massage therapist or registered massage practitioner periodically may renew it for an additional term, if the licensed massage therapist or registered massage practitioner: Otherwise is entitled to be licensed or registered; Submits to the Board a renewal application on the form that the Board requires; and Pays to the Board a renewal fee set by the Board. Each licensed massage therapist or registered massage practitioner shall notify the Board in writing of any change in the name or address of the licensed massage therapist or registered massage practitioner within 60 days after the change occurred. If a licensed massage therapist or registered massage practitioner fails to notify the Board within the time required under this subsection, the Board may impose an administrative penalty of $100. The Board shall renew the license of each licensed massage therapist and the registration of each registered massage practitioner who meets the requirements of this section.

If a licensed massage therapist or registered massage practitioner fails for any reason to renew a license or registration, the Board shall reinstate the license or registration if the former licensed massage therapist or former registered massage practitioner: Applies to the Board for reinstatement of the license or registration within 5 years after the license or registration expires; Meets the renewal requirements of § 6–305 of this subtitle; Submits to the Board satisfactory evidence of having completed a State and national criminal history records check in accordance with § 6–303 of this subtitle; and Pays to the Board the reinstatement fee set by the Board. Except as provided in paragraph (2) or (3) of this subsection, the Board may not reinstate the license of a former licensed massage therapist or registration of a former registered massage practitioner who fails to apply for reinstatement of the license or registration within 5 years after the license or registration expires. A former licensed massage therapist may apply for a new license by meeting the licensing requirements in effect at the time of application for obtaining a new license under this title and any additional requirements determined by the Board. A former registered massage practitioner who fails to apply for reinstatement of the registration within 5 years after the registration expires may be reinstated only by meeting the licensing requirements in effect for obtaining a new license under this title and any additional requirements determined by the Board.

Each holder of a license or registration shall display the license or registration conspicuously where the holder is engaged in practice.

The Board shall place a licensed massage therapist or registered massage practitioner on inactive status if the licensee or registration holder submits to the Board: An application for inactive status on the form required by the Board; and The inactive status fee set by the Board. A licensed massage therapist or a registered massage practitioner on inactive status may reactivate the license or registration if the licensee or registration holder: Complies with the continuing education and CPR requirements that are: Established in regulations adopted by the Board; and In effect for the current license or registration renewal period in which the licensee or registration holder seeks to reactivate the license or registration; Submits to the Board satisfactory evidence of having completed a State and national criminal history records check in accordance with § 6–303 of this subtitle; and Pays the reactivation fee set by the Board. A registered massage practitioner on inactive status who fails to reactivate a registration within 5 years of first being placed on inactive status may reactivate the registration only by meeting the licensing requirements in effect for obtaining a new license under this title and any additional requirements determined by the Board.

Unless the Board agrees to accept the surrender of a license or registration of a licensed massage therapist or registered massage practitioner, a licensed massage therapist or registered massage practitioner may not surrender the license or registration nor may the license or registration lapse by operation of law while a licensed massage therapist or registered massage practitioner is under investigation or while charges are pending against the licensed massage therapist or registered massage practitioner. The Board may set conditions on its agreement with the licensed massage therapist or registered massage practitioner under investigation or against whom charges are pending to accept surrender of the license or registration.

Subject to the hearing provisions of § 6–309 of this subtitle, the Board may deny a license or registration to an applicant, reprimand a licensee or registration holder, place any licensee or registration holder on probation, or suspend or revoke the license of a licensee or the registration of a registration holder if the applicant, licensee, or registration holder: Fraudulently or deceptively obtains or attempts to obtain a license or registration for the applicant or for another; Fraudulently or deceptively uses a license or registration; 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; 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; Willfully and knowingly: Files a false report or record of an individual under the care of the licensee or registration holder; or Gives any false or misleading information about a material matter in an employment application; 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; Provides professional services while: Under the influence of alcohol; or 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; Does an act that is inconsistent with generally accepted professional standards in the practice of massage therapy; Is negligent in the practice of massage therapy; Is professionally incompetent; Has violated any provision of this title; Submits a false statement to collect a fee; Is physically or mentally incompetent; Knowingly fails to report suspected child abuse in violation of § 5–704 of the Family Law Article; Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee or registration holder is qualified to render because the individual is HIV positive; Except in an emergency life–threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control and Prevention’s guidelines on standard precautions; Is habitually intoxicated; Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article; Fails to cooperate with a lawful investigation conducted by the Board; Engages in conduct that violates the professional code of ethics; Knowingly does an act that has been determined by the Board to be a violation of the Board’s regulations; Fails to submit to a criminal history records check in accordance with § 6–303 of this subtitle; or Fails to comply with a Board order. If, after a hearing under § 6–309 of this subtitle, the Board finds that there are grounds under subsection (a) of this section to suspend or revoke a license or registration to practice massage therapy, to reprimand a licensee or registration holder, or to place a licensee 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 license or registration, reprimanding the licensee or registration holder, or placing the licensee or registration holder on probation. An individual whose license or registration has been suspended or revoked by the Board shall return the license or registration to the Board. If the suspended or revoked license or registration has been lost, the individual shall file with the Board a verified statement to that effect.

Except as otherwise provided in the Administrative Procedure Act, before the Board takes any action under § 6–308 of this subtitle, the Board shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board. The Board shall give notice and hold the hearing in accordance with the Administrative Procedure Act. The individual may be represented at the hearing by counsel. Over the signature of an officer or the executive director of the Board, the Board may issue subpoenas and administer oaths in connection with any investigation under this title and any hearings or proceedings before it. If, without lawful excuse, a person disobeys a subpoena from the Board or an order by the Board to take an oath or to testify or answer a question, then, on petition of the Board, a court of competent jurisdiction may punish the person as for contempt of court. If, after due notice, the individual against whom the action is contemplated fails or refuses to appear, the Board nevertheless may hear and determine the matter. If, after a hearing, an individual is found in violation of § 6–308 of this subtitle, the individual shall pay the costs of the hearing as specified in regulation adopted by the Board.

Except as provided in this section for an action under § 6–308 of this subtitle, any person aggrieved by a final decision of the Board in a contested case, as defined in the Administrative Procedure Act, may petition for judicial review as allowed by the Administrative Procedure Act. Any person aggrieved by a final decision of the Board under § 6–308 of this subtitle may not appeal to the Secretary but may take a direct judicial appeal as provided in the Administrative Procedure Act. The Board may grant a stay of enforcement of a Board order in accordance with the Administrative Procedure Act. An order by the Board may not be stayed pending judicial review. The Board may appeal a decision that reverses or modifies its order.

An action may be maintained in the name of the State or the Board to enjoin: The unauthorized practice of massage therapy; or Conduct that is a ground for disciplinary action under § 6–308 of this subtitle. An action under this section may be brought by: The Board in its own name; The Attorney General, in the name of the State; or A State’s Attorney, in the name of the State. An action under this section may be brought in the county where the defendant: Resides; or Engages in the act sought to be enjoined. Except as provided in paragraph (2) of this subsection, an action under this section may not be brought against an individual who is authorized to practice a health occupation under this article. An action under this section may be brought against an individual who is authorized to practice massage therapy under this title. Proof of actual damage or that any person will sustain any damage if an injunction is not granted is not required for an action under this section. An action under this section is in addition to and not instead of criminal prosecution for the unauthorized practice of massage therapy under § 6–501 of this title or disciplinary action under § 6–308 of this subtitle.

If a license or registration has been suspended or revoked under § 6–308 of this subtitle, the Board may reinstate that license or registration only in accordance with: The terms and conditions of the order of suspension or order of revocation; or An order of reinstatement issued by the Board.

If the Board, while reviewing an application for licensure or investigating an allegation brought against a licensee under this title, has reason to believe and objective evidence that the applicant or licensee may cause harm to individuals affected by the applicant’s or licensee’s practice of massage therapy, the Board shall require the applicant or licensee to submit to an appropriate examination by a health care provider designated by the Board. In return for the privilege to practice massage therapy in the State, the applicant or licensee is deemed to have: Consented to submit to an examination under this section, if requested by the Board in writing; and Waived any claim of privilege as to the testimony or examination reports of the examining health care professional. The failure or refusal of the applicant or licensee to submit to an examination required under subsection (b) of this section is prima facie evidence of the applicant’s or licensee’s inability to practice massage therapy competently, unless the Board finds that the failure or refusal was beyond the control of the licensee. The Board shall pay the cost of any examination made under this section.