legalities of chest & breast massage in the usa
 

Sources of information:
Home page: http://www.almtbd.state.al.us/
Rules & regulations: http://www.almtbd.state.al.us/PDF/Rules/2014_MAS_Rules_Regulations.pdf

text from the law/rules:
Breast Massage: no reference to breast massage
Draping: breasts and buttocks must be covered at all times
“Each massage therapy establishment must demonstrate…..clean drape material for draping clients during the massage, use of which shall be explained to the client prior to the massage, and which shall cover the buttocks and genitals of a male client at all times during the massage, and which shall cover the buttocks, breasts, and genitals of a female client at all times during the massage.”

information updated: 7/20/16

Sources of information:
https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/BoardofMassageTherapists.aspx

text from the law/rules
Breast massage:
There is no specific info on breast massage in the statutes & regulations, or in the code of ethics.

Draping: “I will respect the client’s autonomy by providing draping and treatment in a way that ensures the safety, comfort and privacy of the client.”  - within the code of ethics

communication with the Alaska Board of Massage Therapists
2016/07/20: I emailed at randy.brown@alaska.gov to ask if they have rules about breast massage  now, or if they are in the process of writing such rules. email sent to:  randy.brown@alaska.gov.  

I received this reply: "I am not aware of any state laws on these issues outside of the statutes and regulations found on the Board of Massage Therapists web page at https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/BoardofMassageTherapists.aspx.  The board is not actively writing any regulations on this topic, and I am not aware of a lobby to our state legislature to amend state law."

information updated: 7/20/16

sources of information:
http://www.mass.gov/ocabr/licensee/dpl-boards/mt/
Statutes and regulations: http://www.mass.gov/ocabr/licensee/dpl-boards/mt/regulations/
Rules and regulations: http://www.mass.gov/ocabr/licensee/dpl-boards/mt/regulations/269-cmr/

text from the law/rules:
breast massage:
no mention
Draping:
no mention

communication with the Massachusetts Board of Massage Therapy
2016/07/20 – I emailed them to ask if they have rules about breast massage or draping now, or if they are in the process of writing such rules  MassageTherapy@State.MA.US
I received this reply: "Response: Hi Barbara,
If you cannot find the laws, rules in our website which you want to see, it means the board does not have the requirement for it.
Thanks,
FeiYan Chen
Board Administrator
"

information updated: 7/20/16, reviewed in 9/2017 and found no mention of breast massage.

sources of information:
http://www.michigan.gov/lara/
Michigan Department of licensing and regulatory affairs (LARA), professional licensing section, health professional licensing, massage therapy.  - I have been unable to correctly copy the web address for this page.
public health code: http://www.legislature.mi.gov/(S(j5fglr5xqzyrrad52ru5rd2k))/mileg.aspx?page=getObject&objectName=mcl-368-1978-15-179A.
I haven't found a set of rules for Michigan massage therapy

text from the law/rules:
breast massage:
no mention
Draping:
no mention

Scope of practice: (d) "Practice of massage therapy" means the application of a system of structured touch, pressure, movement, and holding to the soft tissue of the human body in which the primary intent is to enhance or restore the health and well-being of the client. Practice of massage therapy includes complementary methods, including the external application of water, heat, cold, lubrication, salt scrubs, body wraps, or other topical preparations; and electromechanical devices that mimic or enhance the actions possible by the hands. Practice of massage therapy does not include medical diagnosis; practice of physical therapy; high-velocity, low-amplitude thrust to a joint; electrical stimulation; application of ultrasound; or prescription of medicines.

R 338.723   Prohibited conduct.    Rule 23.  Prohibited conduct includes, but is not limited to, the following acts or omissions by an individual covered by these rules:  
(a)  Practicing outside of the boundaries of professional competence, based on education, training, and experience. This includes, but is not limited to, providing massage therapy services without ensuring the safety, comfort, and privacy of the client.
(g)  Being involved in a dual or multiple relationship with a current or former client, when there is a risk of harm to, or exploitation of, the client. As used in this rule, “dual or multiple relationship” means a relationship in which a licensee is in a professional role with a client and 1 or more of the following occurs at the same time:
 
communication with the  Michigan Board of Professional Licensing
2016/07/20 – I emailed them to ask if they have rules about breast massage or draping now, or if they are in the process of writing such rules.  I also asked them if they have a set of rules governing massage therapy.  BPL-BoardSupport@michigan.gov

I received this reply:

Ms. Heard,
The State of Michigan does not prohibit breast massage, specifically.  Nor does it require draping by law.
The scope of practice for massage therapists is defined at  MCL 333.17951(1)(d).  Prohibited conduct by licensees is outlined in R 338.723 of the  Massage Therapy Rules.  Subrules (a) and (g) appear to be most applicable to your question.  The State also has  MCL 333.16221(e)(vi), which allows the Board of Massage Disciplinary Committee to sanction a licensee for “any conduct by a health professional with a patient while he or she is acting within the health profession for which he or she is licensed or registered . . . that is sexual or may reasonably be interpreted as sexual, including . . . touching of a body part for any purpose other than appropriate examination, treatment, or comfort.”
Regards,
Michael Siracuse (P75512)
Senior Policy Analyst
Boards and Committees Section
Legal Affairs Division
Bureau of Professional Licensing
Department of Licensing and Regulatory Affairs
611 W. Ottawa St., 3rd Floor
Lansing, MI 48909
siracusem@michigan.gov

information updated: 7/20/16

Minnesota does not license massage therapists at the state level.  There may be regulations in individual towns, cities or counties.

information updated: 7/20/16

sources of information:
https://www.msbmt.state.ms.us/msbmt/web.nsf
Rules and regulations, effective Dec 1, 2014 
https://www.msbmt.state.ms.us/msbmt/web.nsf/webpageedit/Exams_Page_Exams_Rules/$FILE/MSBMT%20Rules%20Regulations%20Final%2012.1.2014.pdf?OpenElement

text from the law/rules:
breast massage and draping:
massage therapists must…..
10. Provide and use draping to cover all genitalia;
14. The massage therapist shall provide and use draping to cover female breast unless prior written consent is given for breast massage

Frequently asked questions
https://www.msbmt.state.ms.us/msbmt/web.nsf/webpages/LN_FAQs_Page_FAQ?OpenDocument
Is breast massage legal in Mississippi?  
Breast massage is not illegal in Mississippi, however due to the sensitivity of the procedure, it carries rules and responsibilities.  See Rules and Regulations, Section 705.A. which states ‘perform only those services for which they are qualified and which represent their training and education.’  Also refer to MSBMT Code of Ethics which state that a LMT must ‘represent their qualifications honestly, including education and professional affiliations, and provide only those services, which they are qualified to perform’; ‘provide draping and treatment in a way that ensures the safety, comfort and privacy of the client.  Provide and use draping to cover all genitalia and female breast unless prior written consent is given for breast massage’ and ‘Respect the client’s right to refuse, modify, or terminate therapy regardless of prior consent given’.

information updated: 7/20/16

sources of information:
http://pr.mo.gov/massage.asp
rules and regulations: http://www.sos.mo.gov/adrules/csr/current/20csr/20csr.asp#20-2197  (division 2197, 2/3 down page)
standards of practice: http://s1.sos.mo.gov/cmsimages/adrules/csr/current/20csr/20c2197-3.pdf

text from the law/rules:
breast massage:
a licensee ……Shall not massage the breast unless ordered by a physician prescription or by documented clinical indication. Such documentation shall be included in the client’s record and the massage shall be performed by a licensee that is certified or has advanced training in techniques related to therapeutic treatment of mammary tissue;
Draping:
a licensee shall…. Provide appropriate draping during treatment which includes draping at the gluteal cleft and genitals on males and females and the breasts on females;

information updated: 7/20/16

sources of information:
http://b.bsd.dli.mt.gov/license/bsd_boards/lmt_board/board_page.asp
Statutes:  http://b.bsd.dli.mt.gov/license/bsd_boards/lmt_board/board_page.asp
Rules: http://b.bsd.dli.mt.gov/license/bsd_boards/lmt_board/board_page.asp

text from the law/rules:
breast massage:
no rules found
Draping:
no rules found

communication with the Montana Board of Massage Therapy
2016/07/20 – I emailed them via their website to ask if they have rules about breast massage or draping now, or if they are in the process of writing such rules.  I also asked them if they have a set of rules governing massage therapy.    http://b.bsd.dli.mt.gov/license/bsd_boards/lmt_board/email_form.asp


I haven't yet received a reply.

information updated: 7/20/16

sources of information:
http://dhhs.ne.gov/publichealth/Pages/crl_mhcs_mass_massestab.aspx
Rules and regulations: http://dhhs.ne.gov/publichealth/Pages/crl_mhcs_mass_massestab.aspx#Rules
Statutes: http://dhhs.ne.gov/publichealth/Documents/Massage%20Therapy.pdf
Rules: title 172, chapter 81

text from the law/rules:
breast massage:
no mention
Draping:
81-008.02F Draping: A massage therapist must maintain appropriate draping for each client to ensure the comfort level of both the therapist and client.

communication with the Nebraska Board of Massage Therapy
2016/07/20 – I emailed them to ask if they have rules about breast massage  now, or if they are in the process of writing such rules.   rita.watson@nebraska.gov

I have not yet received a reply.

information updated: 7/20/16

sources of information:
http://dhhs.ne.gov/publichealth/Pages/crl_mhcs_mass_massestab.aspx
Rules and regulations:
http://massagetherapy.nv.gov/
Rules and regulations: http://massagetherapy.nv.gov/About/Regulations/
Statute: http://www.leg.state.nv.us/NRS/NRS-640C.html

text from the law/rules:
breast massage & draping:
 NRS 640C.700  Grounds for refusal to issue license or for disciplinary action.  The Board may refuse to issue a license to an applicant, or may initiate disciplinary action against a holder of a license, if the applicant or holder of the license:
      1.  ….
      (c) Massaged, touched or applied any instrument to the breasts of the person, unless the person has signed a written consent form provided by the Board;

Code (rules) http://www.leg.state.nv.us/nac/NAC-640C.html
NAC 640C.400  “Sexual activity” interpreted. (NRS 640C.320)  As used in subsection 4 of NRS 640C.700, the Board interprets the phrase “sexual activity” to include, without limitation:
     1.  …..
     7.  Not providing a client a gown or draping except as may be necessary in a medical emergency;
     8.  Removing the client’s clothing or gown or draping without consent, except as may be necessary in a medical emergency or in a custodial setting;

Breast massage consent form: http://massagetherapy.nv.gov/uploadedFiles/lmtnvgov/content/Licensees/Informed%20Consent%20Breast%20Massage.pdf: specifies that no touch of nipples or areola allowed

information updated: 7/20/16

sources of information:
http://www.dhhs.nh.gov/oos/blc/massage/
Laws and rules:  http://www.dhhs.nh.gov/oos/blc/massage/massage-law-rule.htm
Laws: http://www.gencourt.state.nh.us/rsa/html/XXX/328-B/328-B-mrg.htm
Rules: http://www.gencourt.state.nh.us/rules/state_agencies/he-p900.html

text from the law/rules:
Rules:
(l)  “Inappropriate sexual contact” means the intentional touching by the massage therapist of the client’s breasts or genitalia when such touching:
(1)  Is a therapeutic aspect of the massage, but is done without the informed consent of the client; or
(2)  Is not a necessary, therapeutic aspect of the massage; and
(3)  Is performed primarily for the purpose of sexual arousal or gratification of the massage therapist or the client.

communication with the NH department of health and human services via their website
10/15/15 I received this message from NH-DHHS-WebMail@dhhs.state.nh.us
Thank you for asking about the NH Massage Therapy Rules on Draping.  I am sending you the MT Rules of Part He-P 901.01 Definitions.  Below is also a reply from the Advisory Board Chair of Massage Therapy.

We do not have any regulations in regards to draping or how to massage the chest area. The only direction is in the rules under definitions; section L. There are 3 lines, need informed consent, therapeutically needed, not for sexual gratification. As long as they follow those 3 guidelines they are following NH's rules and regs.

Connie Beliveau
NH Massage Therapy License Clerk
(603) 271-9254

information updated: 7/20/16

sources of information:
http://www.njconsumeraffairs.gov/mbt/Pages/default.aspx
Laws and regulations: http://www.njconsumeraffairs.gov/mbt/Pages/regulations.aspx
Statutes: http://www.njconsumeraffairs.gov/Statutes/massagelaw.pdf
Administrative code (rules) http://www.njconsumeraffairs.gov/regulations/Chapter-37A-New-Jersey-Board-of-Massage-and-Bodywork-Therapy.pdf (this includes scope of practice)

text from the law/rules:  (there is no specific mention of breast massage in their rules)

scope of practice
13:37A-3.1 SCOPE OF PRACTICE
a) A licensee shall practice only those methods of massage and bodywork therapy that:
1) The licensee learned during his or her initial training as outlined in N.J.A.C. 13:37A-2.1 or 2.5;
2) The licensee learned during a course offered by:
i. A provider approved by the NCBTMB, NCCAOM, American Massage Therapy Association (AMTA), Associated Bodywork and Massage Professionals (ABMP), FSMTB, American Nurse Credentialing Center (ANCC), American Organization for Bodywork Therapies of Asia (AOBTA), American Polarity Therapy Association (APTA), American Physical Therapy Association (APTA), American Medical Association (AMA), International Association of Structural Integrators (IASI), Ida P. Rolf Research Foundation, a state board of massage, a state board of massage and bodywork, a state board of physical therapy or a state board of chiropractic;
ii. A school which is approved by an agency recognized by the United States Department of Education; or
iii. A school which is accredited or approved by the New Jersey Department of Education, the New Jersey Department of Labor and Workforce Development, the New Jersey Commission on Higher Education, or an agency of another state with requirements substantially similar to the requirements of the New Jersey Department of Education, the New Jersey Department of Labor and Workforce Development or the New Jersey Commission on Higher Education; or
3) The licensee developed and which are taught, or have been taught, in a course offered by a provider approved by the NCBTMB, NCCAOM, American Massage Therapy Association (AMTA), Associated Bodywork and Massage Professionals (ABMP), FSMTB, American Nurse Credentialing Center (ANCC), American Organization for Bodywork Therapies of Asia (AOBTA), American Polarity Therapy Association (APTA), American Physical
Therapy Association (APTA), American Medical Association (AMA), International Association of Structural Integrators (IASI), Ida P. Rolf Research Foundation, a state board of massage, a state board of massage and bodywork, a state board of physical therapy or a state board of chiropractic.

b) Notwithstanding any training received as permitted by (a) above, a licensee shall not perform:
1) Vaginal or penile massages;
2) Animal therapies prohibited by the Veterinary Medical Act, N.J.S.A. 45:16-1, et seq.;
3) Any application of electrical current to the body (Transcutaneous Electronic Nerve
Stimulation, TENS, machine); and
4) Diagnosis of illness, disease, impairment or disability.

draping and breast massage
Draping/Infection control: Clean linens and drapes or disposable coverings shall be used for each client.
Sexual misconduct includes: A licensee shall provide privacy and therapy conditions which prevent the exposure of the unclothed body of the client. Appropriate draping measures shall be employed to protect client privacy.

communication with the NJ consumer affairs department
2016/07/20 – I emailed them via their website to ask if they have rules about breast massage now, or if they are in the process of writing such rules.  askconsumeraffairs@dca.lps.state.nj.us.  They replied on 2016/12/14 and referred me to the scope of practice rules which I've included above.  link:  http://www.njconsumeraffairs.gov/regulations/Chapter-37A-New-Jersey-Board-of-Massage-and-Bodywork-Therapy.pdf

information updated: 12/14/16

sources of information:   
Rules and laws home page:https://www.rld.nm.gov/boards-and-commissions/individual-boards-and-commissions/massage-therapy/mt-laws-rules-and-policies/

New Mexico Statutes.  See chapter 61, article 12-c.     https://nmonesource.com/nmos/nmsa/en/item/4397/index.do#!fragment/zoupio-_Toc84933885/BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoAvbRABwEtsBaAfX2zgA4AWATgGY+HDgFYAlABpk2UoQgBFRIVwBPaAHI14iITC4ECpao1adekAGU8pAEKqASgFEAMg4BqAQQByAYQfjSYABG0KTsoqJAA

New Mexico Rules: https://www.srca.nm.gov/chapter-7-massage-therapists/

(There is lots of overlap in the links to rules and statutes.)

text from the law/rules:
breast massage: no specific rules

However, CODE OF PROFESSIONAL CONDUCT includes:

Competence:  Each licensee and applicant shall:  (1)  limit practice and instruction to the areas of competence in which proficiency has been gained through education, training, and experience and refer clients to other health professionals when appropriate; ....

draping and general massage, in the code of professional conduct:
(2)  CODE OF PROFESSIONAL CONDUCT:

Client welfare:  Each licensee and applicant shall: .... 

(2) obtain prior informed consent of the client regarding draping and treatment to ensure the safety, comfort and privacy of the client;

(3) provide privacy for the client while the client is dressing or undressing;

....

information reviewed/updated: 11/09/21

sources of information:
http://www.op.nysed.gov/prof/mt/mtlic.htm
rules and laws: http://www.op.nysed.gov/prof/mt/mtlaw.htm
http://www.op.nysed.gov/title8/part29.htm
http://www.op.nysed.gov/prof/mt/mtguide.htm

text from the law/rules:
breast massage:
When massage of breast tissue is therapeutically indicated, the female patient/client must be fully informed and give consent before the therapist undrapes the breast for treatment.
draping:
the provisions of Section 29.1(b)(5) of this Part prohibiting immoral conduct shall apply in the practice of massage therapy. Massage of genital areas and massage of a client who is not properly draped for massage, or by a massage therapist who is not properly dressed, shall be considered immoral conduct;
•    Massage of genital areas and massage of a patient/client who is not properly draped for massage shall be considered immoral conduct.
•    The practice of massage by a massage therapist who is not properly dressed shall be considered immoral conduct.
•    Draping includes methods used by a massage therapist to protect modesty, privacy, warmth and/or comfort of a patient/client by the use of sheets, towels, blankets or any item that serves this purpose.
 
information updated: 7/20/16

sources of information:
https://www.bmbt.org/
Practice act and rules: https://www.bmbt.org/pages/DocumentCenter.html
Practice act: https://www.bmbt.org/downloads/Practice%20Act%20With%20Revisions%2007-08-3.pdf
Rules: https://www.bmbt.org/downloads/Rules%20and%20Regulations%20Revised%2010-2015.pdf

text from the law/rules:
breast massage and draping:
Licensees shall adhere to the following requirements, except in the case of treatments where the client remains fully clothed:
(1) provide draping in a manner that ensures the safety, comfort and privacy of the client;
(2) maintain a supply of clean drapes, such as towels, sheets, gowns or other coverings, for the purpose of draping the client's body during treatment;
(3) explain expected draping procedures to the client before treatment; and
(4) ensure that the following areas are draped during treatment: the gluteal and genital areas for male and female clients, and the breast area for female clients. With voluntary and informed consent of the client, the gluteal and breast drapes may be temporarily moved in order to perform therapeutic treatment to structures in those areas.

information updated: 7/20/16

sources of information:
http://www.ndboardofmassage.com/
Laws and rules: http://www.ndboardofmassage.com/laws-and-rules-tab/
law: http://www.legis.nd.gov/cencode/t43c25.pdf?20150902110347
rules:  http://www.legis.nd.gov/information/acdata/pdf/49-03-01.pdf

text from the law/rules:
breast massage:
no rules
draping:
A therapist must provide draping and treatment in a way that ensures the personal safety, comfort, and privacy of the client.

communication with the North Dakota Board of Massage
2016/07/20 – I emailed them to ask if they have rules about breast massage now, or if they are in the process of writing such rules.  pb.lmt.nd@gmail.com

I received this reply: "Barbara, Thank you for opening discussion on an interesting topic. As of this time we have no specific law or rule on this issue but it is certainly something for us to consider in the upcoming months. When we do discuss this topic, may I use you for information and reference since it seems you are compiling data?
Again, thank you for your interest and have a wonderful day.
Pat Berg"

information updated: 7/20/16

sources of information:
Ohio laws and rules group laws for massage therapists together some other health care professions using the terms "limited branches of medicine and surgery" and "Physicians: Limited Practitioners".

Ohio rules/laws do not specifically allow, prohibit, or establish guidelines for massage of the breasts.  In the scope of practice rule (see massage therapy scope of practice link below) massage therapy is defined as "the treatment of disorders of the human body by the manipulation of soft tissue through the systematic external application of massage techniques including touch, stroking, friction, vibration, percussion, kneading, stretching, compression, and joint movements within the normal physiologic range of motion; and adjunctive thereto, the external application of water, heat, cold, topical preparations, and mechanical devices."    This is followed by a list of actions that are specifically excluded from a massage therapist's scope of practice; breast massage is not included on that list.  Breast massage is therefore allowed. 

The exeption, as is the common in all states, is that all sexual touch is prohibited.

• statutes table of contents for all health care providers :  http://www.med.ohio.gov/Laws-Rules/Statutes
• Statutes details for "physicians; Limited Practitioners  : http://codes.ohio.gov/orc/4731
• rules table of contents (Ohio Administrative Code all health care practitioners): http://codes.ohio.gov/oac/4731
• rules table of contents for "Physicians; Limited Practioners":  administrative rules, massage scope of practice, plus lots more: http://codes.ohio.gov/oac/4731-1
• massage therapy scope of practice: Rule 4731-1-05 - Ohio Administrative Code | Ohio Laws
• Rules on sexual conduct and impropriety:  http://codes.ohio.gov/oac/4731-26   

text from the law/rules:

See paragraph above for the definiton of massage.
breast massage:
Chapter 4731-26 Sexual Misconduct and Impropriety
(2) "Sexual contact" includes, but is not limited to, the following: (a) Touching a breast or any body part that has sexual connotation for the licensee or patient, for any purpose other than appropriate health care services, or where the patient has refused or has withdrawn consent; 
 
draping:
Chapter 4731-26 Sexual Misconduct and Impropriety
(1) "Sexual impropriety" means conduct by the licensee that is seductive, sexually suggestive, disrespectful of patient privacy, or sexually demeaning to a patient, including but not limited to, the following:
(a) Neglecting to employ disrobing or draping practices respecting the patient's privacy;
...

information reviewed and/or updated: 8/12/23

State level licensing approved 5/2016 under the Board of cosmetology and barbering

sources of information:
https://www.ok.gov/cosmo/
the law creating the massage license:  http://webserver1.lsb.state.ok.us/cf_pdf/2015-16%20ENR/SB/SB687%20ENR.PDF

text from the law/rules:
Don’t appear to be any rules yet.  The board of cosmetology and barbering website does not mention massage.

communication with the Oklahoma Cosmetology department
I sent a message via the website asking who is writing the rules.  https://www.ok.gov/triton/contact.php?ac=191&id=167 

I have not yet received a reply.

information updated: 7/20/16

sources of information:
http://www.oregon.gov/OBMT/Pages/index.aspx    index
Rules:
https://oregon.public.law/rules/oar_334-010-0028   breast massage rules

https://oregon.public.law/rules/oar_334-010-0025   draping rules

https://oregon.public.law/rules/oar_334-040-0010   discipline rules

text from the law/rules:
breast massage: 334-010-0028
(1) Prior to performing breast massage to treat certain medical conditions, a LMT must:
(a) Be able to present evidence of the completion of specialized contact hours as training beyond the minimum competencies, which includes but is not limited to, indications, contraindications, therapeutic treatment techniques, expected outcomes, client safety, client consent, client communication, draping techniques, sanitation, and ethical responsibilities related to breast massage;
(b) Be able to articulate a therapeutic rationale which is acknowledged by the client; rationale may include a medical prescription and/or permission to consult with the clients health care provider(s).
(c) Acquire prior written and verbal consent before proceeding; the written consent must include clients option to accept or decline to provide a witness, in addition to the client and LMT.
(2) While performing these procedures a LMT must use appropriate draping techniques at all times. Any temporary exposure of the breast area for the purposes of treatment is acceptable only in respect to appropriate procedures for that treatment. Immediately following treatment of the area, the breast area must be covered again.
(3) Additional prior written consent and the actual presence of a parent or legal guardian is required when treating individuals under 18 years of age.

draping:
334-010-0025  Practice of Massage  
......
(3) A massage therapist must use safe and functional coverage/draping practices during the practice of massage when the client is disrobed.
(a) Safe and functional coverage/draping means:
(A) LMT explains, maintains and respects coverage/draping boundaries;
(B) Client gives informed consent;
(C) Genitals and gluteal cleft of male and female clients and the breast area of female clients are not exposed; with voluntary and informed consent of the client, the gluteal and breast drapes may be temporarily moved in order to perform therapeutic treatment of the area.
(D) Massage or movement of the body does not expose genitals, gluteal cleft or breast area.
(b) Exceptions to the rule may be made for LMTs who can document training in specific modalities that require variations in coverage/draping.
.....

334-040-0010  Discipline 

The Board may deny, conditionally grant, restrict, suspend or revoke a license or permit, impose probation, reprimand, censure, impose remedial education or corrective actions, and/or impose a civil penalty for any of the following reasons: 
...........
(25) Unprofessional or dishonorable conduct which includes but is not limited to:
(a) Any conduct involving inappropriate physical contact or sexual misconduct which includes:
(A) Sexual abuse which is conduct which constitutes a violation of any provision of ORS 163.305 through 163.465;
(B) Sexual violation which is sex between the LMT and the client, whether initiated by the client or not, engaging in any conduct with a client that is sexual, or may be reasonably interpreted as sexual, including, but not limited to:
(i) Sexual intercourse;
(ii) Genital to genital contact;
(iii) Oral to genital contact; oral to anal contact;
(iv) Oral to oral contact except cardiopulmonary resuscitation; touching breasts or genitals or any sexualized body part for any purpose other than appropriate examination or treatment or where the client has refused or withdrawn consent; or
(v) .....
....

information verified/updated: 3/08/20

sources of information:
Pennsylvania Code/rules: http://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter20/chap20toc.html 

text from the law/rules:
breast massage:
Standard of Professional conduct includes: "(a) A massage therapist shall..... (7)  Obtain written consent prior to performing breast massage."  .....    "(b)  A massage therapist may not: ......   (5)  Intentionally expose a client’s genitals, gluteal cleft or the breasts of a female client except temporarily to perform therapeutic treatment of the area."

draping:
Standard of professional conduct includes: "A massage therapist shall......(10)  Use safe and functional coverage/draping practices during the practice of massage therapy when the client is disrobed. Safe and functional coverage/draping means that the client’s genitals and gluteal cleft and the breast area of female clients are not exposed and that massage or movement of the body does not expose genitals, gluteal cleft or breast area. With voluntary and informed consent of the client, the gluteal and breast drapes may be temporarily moved in order to perform treatment of the area."

information updated: 7/16/21

sources of information:
http://www.health.ri.gov/licenses/detail.php?id=229
Rules: http://sos.ri.gov/documents/archives/regdocs/released/pdf/DOH/7016.pdf

text from the law/rules:
breast massage:
no rules
draping:
no rules

communication with the Rhode Island health department
2016/07/20 – I emailed them to ask if they have rules about breast massage and/or draping now, or if they are in the process of writing such rules. 
http://www.health.ri.gov/contact/

I received this reply:
"Good Morning,
Please see Chapter 23-20. 8-9 (7) of the RI Statute: Nothing in the section shall be construed to prevent or restrict the practice of any person in this state who uses touch to affect the energy systems, acupoints or Qi meridians (channels of energy) of the human body while engaged within the scope of practice of a  profession with established standards and ethics, provided that his or her service is not designated or implied to be massage or massage therapy. Such practices include, but are not limited to, Polarity, Polarity Therapy, Polarity Bodywork Therapy, Rosen Method, Asian Bodywork Therapy, Acupressure, Jin Shin Do/rs, Qi Gong, Reiki and Shiatsu. Practitioners must be recognized by or meet the established standards of either a professional organization or credentialing agency that represents or certified the respective practice based on a minimal level of training, demonstration of competency and adherence to ethical standards.
 
There is no mention of breast massage.
It is out of my jurisdiction.
At the present time the board is not in the process of writing such rules.
 
Alana Rodriguez
Board Manager
Center for Professional Boards and Commissions
RI Department of Health
(t) 401.222.1392
(fax) 401.222.2158"

information updated: 7/20/16

I am in the process of updating this section, and waiting for response to my request for information from the SC massage/bodywork panel (board).   Jan 12, 2021

sources of information: I have found no mention of breast massage or draping in the laws regulating massage in SC, nor of any standards of conduct.  These are links to the general massage laws in SC

https://www.llr.sc.gov/mas/  (information about massage/bodywork panel)
https://www.scstatehouse.gov/code/t40c030.php  (massage/bodywork practice act)
https://www.scstatehouse.gov/coderegs/Chapter%2077.pdf  (chapter 77, massage/bodywork therapy)

the FAQ below is text from the law/rules in 2016:  (as of Jan 12, 2021 I have not been able to find the current Standards of Conduct.  I am waiting for response from the S.C. panel (board)
Frequently Asked Questions
B. Standards of Conduct
1. Draping of Clients: Licensees shall provide a clean drape for each client for the purpose of maintaining professional standards, and to ensure the clients safety, comfort, and privacy. The areas that must be draped are the gluteal and genital areas for male and female clients, and the breast area for female clients. The drape may be adjusted in order to perform therapeutic treatment to the gluteal and breast tissue.
2. Breast Massage: For the protection of the client and the massage therapist, massage of the breasts must be performed in a professional and ethical manner and with prior written consent from the client or physician referral on file. When medical reasons are involved and contraindications may be an issue, a physician's referral is necessary.

information updated: 1/12/21

sources of information:
https://doh.sd.gov/boards/massage/
Statute/laws: http://sdlegislature.gov/statutes/Codified_laws/DisplayStatute.aspx?Statute=36-35&Type=Statute
Rules: http://sdlegislature.gov/Rules/DisplayRule.aspx?Rule=20:76

text from the law/rules:
breast massage
no rules
draping
no rules

communication with the South Dakota Board of Massage
2016/07/21 – I emailed them to ask if they have rules about breast massage and/or draping now, or if they are in the process of writing such rules.  SDBMT@midwestsolutionssd.com

I have not yet received a reply.

information updated: 7/21/16

sources of information:
statutes and rules: https://www.tn.gov/health/health-program-areas/health-professional-boards/ml-board/ml-board/statutes-and-rules.html
rules: https://publications.tnsosfiles.com/rules/0870/0870-01.20170817.pdf

text from the law/rules:
breast massage:
Massage therapists must refrain, under all circumstances, from providing the following treatments, which are prohibited and not within the scope of practice for massage therapists:... (b) Cross-gender breast massage; ...

Respect the client’s right to treatment with informed and voluntary consent by obtaining and recording informed voluntary written consent of the client, or client’s advocate, before performing:  …(3) Therapeutic same-gender breast massage; ...

draping
Before beginning a massage, the therapist must explain to the client the draping techniques that will be used and provide the client a clean drape large enough for the purpose of draping the buttocks and genitalia and, in the case of female clients, the breasts.  Such body parts must remain covered except during therapeutic treatment of those specific areas, with the exception of the genitalia, which shall always remain covered.

information updated: 9/20/19

sources of information:
https://www.dshs.texas.gov/massage/mt_rules.shtm
https://www.dshs.state.tx.us/massage/mt_consult.shtm

text from the law/rules:
draping and general
Licensees are required to provide an initial consultation to each client prior to the first massage session and obtain the signature of the client on a consultation document. The document must include:
•    the type of massage techniques the registrant anticipates using during the massage therapy session;
•    the parts of the client's body that will be massaged or the areas of the client's body that will be avoided during the session, including indications and contraindications;
•    a statement that the licensee shall not engage in breast massage of female clients without the written consent of the client;
•    a statement that draping will be used during the session, unless otherwise agreed to by both the client and the licensee;
•    a statement that if uncomfortable for any reason, the client may ask the licensee to cease the massage and the licensee will end the massage session; and
•    the signature of both the client and the licensee.

Breast massage:
(a) A licensee shall not engage in sexual contact during a session with a client. For the purposes of this section, sexual contact includes:
    (1) any touching of any part of the genitalia or anus;
    (2) any touching of the breasts of a female client, unless the touching is breast massage that is specifically authorized by the client through the signed consultation document referenced in §140.304(a)(3) of this title (relating to Consultation Document);

(j) For purposes of this section:
(1) "Nude" means a person who is:
(A) entirely unclothed; or
(B) clothed in a manner that leaves uncovered or visible through less than fully opaque clothing any portion of the breasts below the top of the areola of the breasts or any portion of the genitals or buttocks.

(2) "Sexual contact" includes:
(A) any touching of any part of the genitalia or anus;
(B) any touching of the breasts of a female client, unless the touching is breast massage that is specifically authorized by the client through the signed consultation document referenced in §140.304(a)(3) of this title (relating to Consultation Document);

information updated: 7/21/16

sources of information:
http://www.dopl.utah.gov/licensing/massage_therapy.html
massage therapy practice act http://le.utah.gov/xcode/Title58/Chapter47B/58-47b.html
rules:  http://www.dopl.utah.gov/laws/R156-47b.pdf

text from the law/rules:
breast massage:
from the massage therapy practice act:
Definitions: (2) "Breast" means the female mammary gland and does not include the muscles, connective tissue, or other soft tissue of the upper chest.
58-47b-501.  Unlawful conduct.
     "Unlawful conduct" includes:  ….
(3)    massaging, touching, or applying any instrument or device by a licensee in the course of practicing or engaging in massage therapy to:
(a)    genitals or anus; and
(b)    breasts of a female patron, except when a female patron requests breast massage, as may be further defined by division rule, and signs a written consent form, which must also include the signature of a parent or legal guardian if the patron is a minor, authorizing the procedure and outlining the reason for it before the procedure is performed.
(Note: the rules do not address breast massage.)
draping:
From the rules:
 (2) "Body wrap" means a body treatment that:
(a) may include one or more therapeutic preparations;
(b) is not for cosmetic purposes; and
(c) maintains modesty by draping the body fully or partially.
R156-47b-502. Unprofessional Conduct.
"Unprofessional conduct" includes: ….
(7) failure to use appropriate draping procedures to protect the client's personal privacy;

information updated: 7/21/16

Vermont does not license massage therapists at the state level.  There may be regulations in individual towns, cities or counties.

information updated: 7/20/16

sources of information: (Massage is regulated by DOH department of nursing.)
http://www.dhp.virginia.gov/nursing/nursing_laws_regs.htm
Regulations governing the certification of massage therapists can be downloaded from this website↑.
http://www.dhp.virginia.gov/nursing/nursing_guidelines.htm - massage therapist section 90-47

text from the law/rules:
draping and breast massage rules
Areas that should be draped and not touched unless medically indicated for a condition referred by a physician, nurse practitioner or physician assistant and with the written informed consent of the client include:  Anus, penis, testicles, scrotum, vagina, labia, clitoris, nipples, and areola.

communication with the Virginia DOH department of nursing.
7/19/16  I emailed nursebd@dhp.virginia.gov to ask whether they have regulations for breast massage or draping.

They replied:
Ms. Heard,
Please see the section on the left hand side of the Virginia Board of Nursing website titled: Guidance Documents.  See Guidance Document 90-47 under  Massage Therapist

Latasha Austin
Discipline Specialist & Massage Therapy Certification Specialist
Department of Health Professions
Virginia Board of Nursing
9960 Mayland Drive, Suite 300
Henrico, Virginia 23233-1463
www.dhp.virginia.gov 

information updated: 7/26/16

sources of information for rules:
http://www.doh.wa.gov/LicensesPermitsandCertificates/ProfessionsNewReneworUpdate/MassageTherapist
Laws and rules/code:  http://www.doh.wa.gov/LicensesPermitsandCertificates/ProfessionsNewReneworUpdate/MassageTherapist/Laws
Laws: http://app.leg.wa.gov/rcw/default.aspx?cite=18.108
Rules/Code: http://app.leg.wa.gov/wac/default.aspx?cite=246-830

below: text from the law/rules: (note: these rules were adopted into law early September, 2021)

WAC 246-830-560 Coverage and draping.

(1) A massage therapist must:

(a) Allow a client or patient privacy to dress or undress except as may be necessary in emergencies or custodial situations; and

(b) Always provide the client or patient a gown or draping except as may be necessary in emergencies.

(2) Massage therapists must use safe, functional, and hygienic coverage and draping practices that comply with WAC 246-830-500 during the practice of massage when the client or patient is disrobed. The drape or drapes must be sufficient to ensure the genitals and the gluteal cleft distal to the coccyx, anus and rectum are not exposed, and the breast area is not exposed except as allowed in subsections (3) and (4) of this section. Safe, functional, and hygienic coverage and draping means:

(a) The massage therapist explains, maintains and respects coverage and draping boundaries;

(b) Massage or movement of the body does not expose genitals or gluteal cleft distal to the coccyx, anus and rectum, or does not expose the breast area except as allowed in subsections (3) and (4) of this section; and

(c) All linens that are used with the client or patient are kept and maintained in accordance with WAC 246-830-500.

(3) With prior signed or initialed written and verbal informed consent from the client or patient, the gluteal cleft and breast drapes may be temporarily moved in order to perform therapeutic treatment of the area consistent with WAC 246-830-550, 246-830-555, and 246-830-557. In addition, with informed and written consent, a client or patient may choose to have their upper torso undraped during the entire massage.

(4) If variations to this coverage and draping rule occur, a massage therapist must:

(a) Maintain evidence of education and training in specific modalities that require variations in coverage and draping;

(b) Receive voluntary and informed consent of the client or patient prior to any variation of coverage or draping; and

(c) Document in the client's or patient's record the rationale for any variation of coverage or draping.

(5) Any written consent required by this section may be included within an overall general consent to massage document, if clearly delineated and either specifically initialed or signed.

WAC 246-830-555  Breast massage.

(1) Prior to performing breast massage, a massage therapist must:

(a) Acquire prior signed or initialed written and verbal informed consent from the client or patient. If the client or patient is under eighteen years of age, prior written consent must be obtained from a parent or legal guardian of the client or patient. The written consent for breast massage may be included within an overall general consent to massage document, if clearly delineated and either specifically initialed or signed. The written consent must:

(i) Be documented and maintained with the client or patient records per WAC 246-830-565 and 246-830-570;

(ii) Include a statement that the client or patient may discontinue the treatment at any time for any reason; and

(iii) Include a statement that the client or patient has the option to have a witness present, and that the witness must be provided by the client or patient.

(b) Use appropriate draping techniques as identified in WAC 246-830-560.

(2) In addition to the requirements identified in subsection (1) of this section, a massage therapist must maintain evidence of the completion of at least sixteen hours of specialized in-person education and training in breast massage beyond the minimum competencies. Education and training in breast massage includes, but is not limited to, breast anatomy and physiology, pathology, indications, contraindications, cautions, therapeutic treatment techniques, draping, appropriate therapist-client or therapist-patient boundaries, expected outcomes, and client or patient safety related to breast massage.

(3) In addition to the requirements in subsections (1) and (2) of this section, prior to performing a massage of the breast that includes the nipples and areolae, a massage therapist must obtain documentation as follows:

(a) A written prescription or referral from a licensed medical health care provider for this specific treatment; or

(b) Prior signed or initialed written and verbal informed consent from the client or patient or from the parent or legal guardian if the client or patient is under eighteen years of age for massage of breast that includes the nipples and areolae. This written consent may be included within the consent for breast massage document.

information updated: 11/11/21

sources of information:
http://doh.dc.gov/service/massage-therapy-licensing
Municipal regulations for massage: http://doh.dc.gov/node/237642

text from the law/rules:
Draping:
Use appropriate draping to protect the client’s physical and emotional privacy.

Breast massage: not mentioned

information updated: 7/21/16

sources of information:
http://www.wvmassage.org/
Rules and regulations: http://www.wvmassage.org/rules.asp
Laws: http://www.wvmassage.org/rules.asp?show=state (no mention of breasts or draping)

text from the law/rules:
Rules: http://www.wvmassage.org/rules.asp
Draping:
4.1.f.  Launder, before reuse, all materials furnished for the personal use of the massage therapy client, such as towels, linens and any draping materials;
4.1.g.  Before proceeding with the massage of a client, explain expected draping techniques and provide the client a clean drape or drapes for the purpose of covering the body in accordance with generally-accepted standards of practice;
Breast massage
4.1.h.  Obtain informed, voluntary consent in writing prior to performing breast massage.  A breast massage may only be performed as indicated in a plan of care.  Failure to comply with this subdivision constitutes grounds for revocation of license;

Information updated: 7/21/16

sources of information:
http://dsps.wi.gov/Default.aspx?Page=3ebd571e-6b70-442f-b8b0-d1b35d0d758f
Statutes and rules: http://dsps.wi.gov/Boards-Councils/Administrative-Rules-and-Statutes/Massage-Therapists-and-Bodyworkers-Administrative-Rules-and-Statutes/
Statutes: https://docs.legis.wisconsin.gov/statutes/statutes/460.pdf  - no mention of draping or breast massage.
Rules: https://docs.legis.wisconsin.gov/code/admin_code/mtbt/5.pdf

text from the law/rules:
Draping:
MTBT 5.02 Unprofessional conduct. “Unprofessional conduct” includes the following, or aiding, abetting, or conspiring the same: …
(21) Failing to provide draping and treatment that ensures the safety and privacy of a client.
Breast massage
not mentioned.

7/21/16  I emailed department of Safety and professional service to ask whether they have regulations for breast massage or draping.  (they oversee massage therapists) dsps@wisconsin.gov 

They replied:
"Good afternoon,
Credential holders are responsible for their own professional practice and for compliance with the law. The Department is unable to answer questions regarding:
·         Potential or ongoing litigation
·         Billing issues
·         Business advice
·         Employer/employee disputes
·         Legal opinions
·         Scope of practice
·         Questions involving professional judgment or discretion
The Department’s website provides a wide range of materials to assist credential holders, as well as the public, in answering questions about the practice of the various professions. These materials include the relevant Wisconsin Statutes, Wisconsin Administrative Code, formal disciplinary orders, meeting minutes, and frequently asked practice questions (Position Statements) developed for many of the professions. The address for the Department’s website is http://dsps.wi.gov.

To find the resources available on this website, please select the Board you are inquiring about from this list, then look for the Statutes and Administrative Codes and/or Position Statements:
Board Council Listing

If after reviewing the website and materials you still have questions, you may submit an item for consideration at a Board or Council meeting by using the following link and filling in the form: 
Public Board Agenda Item
Please let us know if you need further assistance.

Regards,
Ronda Statz
Office Operations Associate
Department of Safety & Professional Services
Division of Professional Credential Processing
1400 East Washington Avenue
Madison, Wisconsin  53703
(608) 266-2112
dsps@wi.gov
The DSPS is committed to service excellence.  Visit our survey at https://www.surveymonkey.com/s/DSPSCustomerServiceCenter to evaluate your experience with the DSPS.

information updated: 7/26/16

Wyoming does not license massage therapists at the state level.  There are regulations in some individual towns, cities and/or counties.

Cheyenne is one city which does regulate massage.  They prohibit massage of female breasts.  In Sept 2019 an LMT trained in breast massage submitted a request to the mayor and city council to allow female breast massage; this discussion may still be ongoing.
municipal code: https://library.municode.com/wy/cheyenne/codes/code_of_ordinances?nodeId=TIT5BULIRE_CH5.52MAES

information updated: 9/20/19