Joint Fact Sheet on: Acupuncture Treatment Provided by Registered Massage Therapists (RMT)

Information for the Public

Can a Registered Massage Therapist Perform Acupuncture?

Yes, acupuncture can be used by RMTs if they are authorized by the College of Massage Therapists of Ontario (CMTO), and it is provided within the Scope of Practice of Massage Therapy and in accordance with Acupuncture Standard of Practice. It can be used safely and effectively alongside of other techniques and treatments that are within an RMT’s Scope of Practice. These RMTs are not called ‘acupuncturists’, but rather use acupuncture as a modality or tool within their Massage Therapy practice. All RMTs authorized to perform acupuncture are listed on the CMTO’s Acupuncture Roster, accessible through the existing public register. An RMT who wishes to provide acupuncture care beyond the Scope of Practice of Massage Therapy must register with the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (CTCMPAO) and practise as a Traditional Chinese Medicine Practitioner and/or Acupuncturist.

How Can RMTs Include Acupuncture as Part of a Massage Therapy Treatment Plan?

Massage Therapy is the assessment of the soft tissue and joints of the body, the treatment and prevention of physical dysfunction and pain of the soft tissues and joints by manipulation to develop, maintain, rehabilitate or augment physical function, or relieve pain. An RMT must first conduct an assessment and determine if acupuncture is an appropriate treatment for the client’s condition. If so, the RMT will incorporate acupuncture into the treatment plan, and it will be considered a modality or tool used as part of the complete treatment. The treatment provided is deemed Massage Therapy and is not considered stand-alone acupuncture.

As RMTs can only practice acupuncture if they are authorized by CMTO and it is within their Scope of Practice, they cannot use it to treat those conditions or issues outside of their Scope (e.g., addiction cessation). Although many educational programs teach acupuncture for conditions which exceed the Massage Therapy Scope of Practice, an RMT who wishes to provide the full breadth of acupuncture care must also be registered with CTCMPAO. Care for conditions outside the Massage Therapy Scope of Practice would not be considered Massage Therapy treatment. RMTs found to be practising either Traditional Chinese Medicine or Acupuncture techniques beyond the Scope of Practice of Massage Therapy risk being charged for misrepresentation to the public. Further, they could be subject to professional misconduct proceedings at the College of Massage Therapists of Ontario (CMTO).

RMTs who provide acupuncture must:

  • follow the College’s Code of Ethics, the Standards of Practice, and the Regulations;
  • conduct an initial client assessment and determine if acupuncture is an appropriate tool to use as part of their treatment plan;
  • possess the knowledge, skill and judgment to perform acupuncture effectively;
  • explain the potential risks and benefits of acupuncture to clients so that they can make informed decisions;
  • obtain valid consent before beginning treatment; and
  • continually evaluate the effects of acupuncture on the client’s condition and overall health.

What is a “Modality”?

A modality is a type of treatment or a tool used to treat a condition. There are a number of modalities that can be used as part of a Massage Therapy treatment plan that are taught outside of the entry-to-practice competencies. These include, but are not limited to: acupuncture; ultrasound; low intensity laser therapy; manual lymph drainage; Active Release Technique (ART); and other similar forms of manual therapy.

RMTs have a professional responsibility to practice within the Scope of Practice for Massage Therapy and to ensure that they do not make unverified claims regarding the effects of any treatment modality they choose to use.

Do RMTs Require Additional Education to Provide Acupuncture?

Yes, RMTs must obtain additional education and are not permitted to practice acupuncture without verification of completion of training and authorization from the College, as outlined in the CMTO’s Standard of Practice for Acupuncture. Information on CMTO’s authorization process is available at www.cmto.com/about-the-profession/rmts-and-acupuncture.

What if an RMT is also Registered in Another Health Profession that Can Provide Acupuncture?

When an RMT is registered in more than one profession, there is potential for clients to be misled about the qualifications or role of the healthcare provider. RMTs must give careful consideration to whether they are using their additional skills and knowledge within the Scope of Practice of Massage Therapy. In some circumstances, it would be appropriate to separate the practices to avoid confusion by clients as to which of the two professions the healthcare provider is practising. If the health professional is practising in a solo practice, it would be considered best practice to maintain separate treatment and financial records for both professions to eliminate the potential for confusion and misrepresentation. For more information on dual registration, please click here.

Can a Client Receive Reimbursement from Extended Health Coverage for Acupuncture Provided by an RMT?

Absolutely, acupuncture provided by an RMT as part of a Massage Therapy treatment is covered by most extended health insurance plans that cover Massage Therapy. When an RMT provides acupuncture as part of a Massage Therapy treatment, a receipt is provided that can be used to seek reimbursement the same way as any other Massage Therapy treatment. This receipt will indicate that Massage Therapy was provided and can be reimbursed as Massage Therapy by extended health insurance.

Can an RMT Issue a Separate Receipt for the Provision of Acupuncture?

This is usually not the case. Acupuncture provided by an RMT as part of a Massage Therapy treatment is billed and reimbursed as Massage Therapy. This is a billing requirement of the RMTs’ regulatory College, the College of Massage Therapists of Ontario (CMTO). If an RMT is also registered as another regulated healthcare practitioner who is able to practice acupuncture, such as a Traditional Chinese Medicine Practitioner or an Acupuncturist, they may be able to provide stand-alone acupuncture treatments that are billed and reimbursed as acupuncture.

Information for Registered Massage Therapists

Is Additional Professional Liability Insurance Needed when Providing Acupuncture as an RMT?

Yes, there is additional coverage needed. The Professional Liability Insurance (PLI) commonly used by RMTs does not cover the use of acupuncture without purchasing additional insurance coverage specifically for the use of acupuncture as a Massage Therapy modality. RMTs should contact their PLI provider for more information on adding acupuncture modality coverage to their insurance. The amount of acupuncture liability coverage needed may depend on the proportion of acupuncture provided in a practice; higher proportions of acupuncture modality use may require increased insurance premiums.

Further PLI coverage is also needed if an RMT aims to become a dual registrant with the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (CTCMPAO) as a Traditional Chinese Medicine Practitioner and/or Acupuncturist. This insurance may be additional to acupuncture modality coverage – already purchased due to the specific requirements outlined by the CTCMPAO and the available insurance packages.