6.2 General Ethics, Billing, Records, and Complaints Notice

Truthful and competent practice

Section 117.90 is titled General Ethical Requirements. It forbids deceptive, untrue, or fraudulent representations and tricks or schemes in massage practice. Examples include a warranty of results and a false claim of proficiency. A therapist may accurately describe training and services but cannot guarantee a cure or exaggerate credentials.

The licensee may not use an unclean or unsanitary work area, equipment, or clothing. The licensee also may not practice fraudulently, with gross incompetence, with gross negligence on one occasion, or with negligence or incompetence on more than one occasion. These standards address conduct and pattern; they do not turn every unfavorable outcome into automatic gross negligence.

Billing, gift certificates, and treatment amount

A licensee bills a client or third party only for services actually rendered or agreed by mutual understanding at the beginning of service or later modified by mutual agreement. A service cannot be added to an invoice merely because the therapist thinks it would have been beneficial.

The licensee must honor an unexpired gift certificate the licensee issued or provide a full refund. Section 117.90 also prohibits overcharging or overtreating a client. These rules work together:

• agree on the service and charge;
• deliver what is billed;
• document any mutually agreed modification;
• do not prolong or multiply treatment for financial gain; and
• honor or refund the licensee's valid, unexpired certificate.

The rule does not establish a statewide massage price. Overcharging depends on the facts, representation, agreement, and service—not simply on charging more than another therapist.

Required records

For every client, a licensee keeps accurate records of dates of massage services, types of massage therapy, and billing information. The records are maintained for at least two years. The rule does not say two years from the last visit; absent a more specific retention trigger, retain each required record for at least two years and follow any other law or risk-management period that applies.

Section 117.82 adds that a massage establishment properly maintains and secures initial consultation documents, all session notes, written consents, and related billing records. The statutes require secure records but do not prescribe SOAP notes, a particular encryption product, or a medical diagnosis. A therapist may use a helpful charting format without representing it as a TDLR mandate.

Do not make an automatic HIPAA claim. Whether a particular therapist is subject to federal or Texas medical-privacy provisions can depend on the person's activities and legal status. For Chapter 117 questions, apply the explicit duties to maintain accurate and secure records, the consultation rules, and lawful department inspection and investigation authority.

Clients under 17 and impairment

Before providing massage to a person under 17, the licensee obtains written parent or guardian consent. This exact age threshold should not be rewritten as under 18.

A licensee may not abuse alcohol or drugs in a manner that detrimentally affects massage therapy or massage instruction. The provision focuses on harmful impairment of professional service. Safe practice requires declining or ending work when judgment or performance is compromised.

Licensed settings and truthful cooperation

A licensee may not practice in an unlicensed massage establishment or school, allow an unlicensed person to perform an activity requiring licensure, or provide false information in material submitted to TDLR. A licensee may not interfere with a department investigation by willful misrepresentation, threats, retaliation, or harassment and must comply with a formal department order relating to the license.

A licensee must respond to a complaint truthfully, fully, honestly, materially responsively, and timely. The rule does not require the licensee to admit an allegation; it requires a truthful and complete response through the process.

Client notice and updates

Each client receives TDLR's name, mailing address, telephone number, and web address for directing complaints. The notice can be provided:

1. on each written service contract;
2. on a sign prominently displayed in the licensee's primary business location;
3. on a bill to the client or third party; or
4. through another written and documented method.

One compliant method is sufficient; the rule does not require all four. Separately, the licensee updates TDLR in writing after changes to name, address, telephone number, or employment.

Scenarios

• Billing 90 minutes after delivering 60 without agreement violates the billing rule.
• Refusing both service and refund on the licensee's unexpired gift certificate violates the certificate rule.
• Keeping only payment totals but no service dates or types leaves required records incomplete.
• Threatening a complainant interferes with the department process.
• Using a prominent complaint-information sign can satisfy client notice; repeating the notice on every bill is not then the only possible route.
• Practicing at a knowingly unlicensed establishment violates the individual licensee's rule even if the therapist does not own the business.

Ethics method

Separate the promise, service, bill, record, and response. Truth and agreement must continue across all five.