How long should massage therapists keep client records

There is no single national rule

Massage therapy is regulated by individual states and territories, and the Federation of State Massage Therapy Boards notes that where a state does not regulate it, county or city ordinances may apply. So the retention period comes from your state's rules, and the numbers differ widely. Three states show the range.

Washington. Under Washington Administrative Code 246-830-570, records for clients 18 and older must be kept by, or stay accessible to, the massage therapist for at least three years from the date of last treatment.

New York. The Board of Regents rules on unprofessional conduct list massage therapy among the health professions they cover and count failing to keep a record that accurately reflects each patient's evaluation and treatment as unprofessional conduct. Unless another law says otherwise, patient records must be kept for at least six years.

Texas. The Texas Department of Licensing and Regulation requires massage therapists to keep accurate records of service dates, types of massage therapy and billing information for each client for at least two years.

Minors change the clock

Records of clients who were minors are usually kept longer. Washington requires them to be kept for at least three years after the client turns 18. New York requires records of minor patients to be kept for at least six years and until one year after the patient reaches 21.

Consent rules for minors differ as well. Texas requires written consent from a parent or guardian before massage for anyone under 17, and Washington requires the record to include a parent's or guardian's contact details when the client is under 18. That consent belongs in the client's file for the same period as the notes.

What counts as the client record

Retention applies to the whole file, not only the session notes. Washington's documentation rule lists what a massage record must include: the client's name, contact details and age, a health history updated at each session, date and duration of treatment, techniques and modalities, the areas of the body treated, and written informed consent, which it treats as valid for one year unless revoked. Correspondence about referrals from other health care providers stays in the file too.

Texas requires a consultation document signed by the client and the therapist before the first session, covering the planned techniques and the areas to be massaged or avoided, and Texas massage establishments must keep and secure each client's consultation documents, session notes, consent documents and billing records. In Florida, a therapist offering massage as a complementary or alternative treatment must keep a patient care record with the assessment methods, the client's condition, the treatment plan, expected outcomes and duration, and the client's signed informed consent.

Tax and business records run on a different clock

Billing records double as tax records, and the IRS sets its own periods. Its guidance for small businesses says to keep records for three years in most cases, six years if you failed to report income that is more than 25 percent of the gross income shown on your return, and seven years if you claim a loss from worthless securities or a deduction for a bad debt. Employment tax records are kept for at least four years, and if a return was never filed, or was fraudulent, there is no time limit.

The IRS also points out that insurance companies or creditors may require you to keep records longer than it does. When one set of papers falls under two rules, the longer period is the one to plan around.

Storing and destroying records safely

Keeping records for years only helps if they survive and stay private. Washington requires massage records to be secured with properly limited access under the state's health care information law and federal privacy rules. Its documentation rule also protects the record itself: entries must be legible and permanent, paper corrections are made with a single line so the original stays readable, and in computer records an entry must not be deleted once the record is signed and locked.

When the period ends, Washington requires disposal in a secure and confidential way, which includes shredding paper, deleting, erasing or reformatting electronic media, or otherwise making the records unreadable.

A record that lives on one device is one lost phone away from gone, so keep a regular copy somewhere as private as the original. SoapDeck, for example, keeps client records on the phone only and exports a session PDF or a backup file when you choose to. Its backup file holds client records but not photos, so before and after photos need their own copy.

Common mistakes

Counting from the first visit. Washington's clock runs from the date of last treatment, so a client who comes back every year keeps restarting it.

Following the shortest rule when two apply. A therapist licensed in more than one state, or whose billing records also serve as tax records, needs to meet the longest period that applies.

Throwing old paper in the recycling. Records past their retention date still hold health information. Shred them.

This article is general information, not legal or tax advice. Rules change and differ by state, and an employer or insurer may set longer periods. Check your massage board's current rules, or ask a lawyer or accountant.

Frequently asked questions