The gateway to massage therapy practice is the licensing exam, and how that exam is administered is becoming a much-talked-about debate.
In 2025, Arkansas explored creating its own state exam to replace the Massage & Bodywork Licensing Examination (MBLEx)—the profession’s only psychometrically valid, reliable, and legally defensible entry-level licensing exam. While the Arkansas bill was killed in the legislature, the MBLEx is used in 46 of the 48 regulated jurisdictions across the country (including Arkansas).
A few states take a different approach. Texas offers two pathways (the Texas Massage Therapy Exam or the MBLEx), while New York and Hawaii rely solely on their state exams. As more jurisdictions consider developing state-specific licensing tests, it raises the question: Does a state exam better serve practitioners or is a national standard the stronger path forward? With more than one option on the table, it’s worth taking a closer look at how each approach measures up.
The Case for State Licensing Exams
At first glance, the idea of a state-specific licensing exam can be appealing. Common arguments include:
- State-tailored content: Exam questions can be designed to reflect a state’s laws and scope of practice. Exam candidates can be tested on exactly what they’ll encounter in their state, particularly around jurisprudence and compliance.
- Regulatory control: State boards may value having direct oversight of the licensure process. Developing an exam internally can provide greater influence over what content is included and define entry-level standards.
- Flexibility: States can quickly update exam content as laws or rules change.
- Alignment with education: A custom exam may better mirror local curriculum and potentially improve pass rates, creating an easy transition from school to licensure.
While these points can seem attractive in concept, their limitations often become apparent when considering long-term impacts, particularly for practitioners.
The Strength in National Exams
Nationally recognized exams like the MBLEx are designed to establish a consistent, objective benchmark for entry-level competence.
- Psychometric validity: National exams are built using rigorous testing standards to ensure reliability, fairness, and accuracy. This process is known as psychometric validation. Without this level of validation, state-developed exams may struggle to prove fairness and impartiality, which is costly if their exam is legally challenged by a test taker.
- License portability: The MBLEx is accepted in 46 states, making it a cornerstone of license mobility. Under most license reciprocity laws, passing a national exam makes transferring your license relatively seamless when relocating. However, a state-specific exam can create portability hiccups. Practitioners may need to retest before practicing in a new state, delaying employment and income.
- Reduced administrative burden: A national exam allows state boards to rely on an already established testing system, rather than building and maintaining one from scratch. Developing an exam requires ongoing time and money. For many state boards, adding administrative responsibilities can cause strain and distract from other priorities.
- Education standards: A widely accepted national exam helps align expectations for entry-level competence across states. If more states move toward individualized exams, it risks fragmenting standards and making it harder to ensure consistent training nationwide.
- Public protection: Consistency in testing supports consistency in care. A validated, standardized exam safeguards competent practice regardless of location.
ABMP’s Commitment to National Standards
It’s important to acknowledge that states that pursue their own exams are doing so with the intention of serving their specific regulatory environments. All states that license massage therapists share the goal of preparing and supporting entry-level practitioners so they may serve their communities safely and competently.
Validated and legally defensible testing, combined with fewer barriers to mobility, strengthens the profession. ABMP supports nationally recognized exams because they provide consistent, high-quality standards across jurisdictions.