{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/massage-therapists/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Massage Therapists",
    "soc_code": "31-9011",
    "category": "Healthcare Support",
    "us_employment": 98790,
    "median_annual_wage": 58450
  },
  "verdict": "SAFE",
  "risk_resistance": 76,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 18,
    "embodiment": 20,
    "liability_shield": 12,
    "trust_premium": 17,
    "judgment_accountability": 9
  },
  "reasoning": {
    "task_resistance": "Locating a hypertonic band in the upper trapezius by feel, then modulating pressure against tissue that changes under your thumb over 50 minutes, has no digital substitute — the only automatable slices are the intake questionnaire and the SOAP note, which is why this sits at 18 rather than the low teens where a mixed-duty job would land.",
    "embodiment": "You are skin-to-skin with a draped body on a table, adjusting your own stance and body weight for deep-tissue work, moving between rooms, spas, chiropractic offices, sports sidelines and client homes with a portable table — there is no screen-based fraction of this job to score down for.",
    "liability_shield": "Roughly 45 states plus DC license massage therapists, typically requiring 500-750 hours and the MBLEx, and you are personally accountable for contraindication screening — working over a DVT, an acute flare, or a client on anticoagulants is your call and your board complaint; it stops short of 16+ because you cannot diagnose, cannot bill as an independent medical provider in most states, and often work under a physician's or chiropractor's referral.",
    "trust_premium": "Clients rebook by name, tolerate a wait for their specific therapist, and disclose pain, trauma history and body-image discomfort while partially undressed — the consent and touch relationship is not transferable to whoever is free at 2pm, which is why repeat clientele carries most practitioners' income.",
    "judgment_accountability": "You decide session structure, pressure depth, and whether to modify or refuse work based on what you palpate and what the client reports, and you refer out when something feels wrong — but the presenting complaint is usually known, the intake screens are standardized, and the consequences of a judgment call rarely reach the irreversible stakes that push this dimension into the teens."
  },
  "rationale": "The core of this job — palpating tissue, adjusting pressure in real time based on a client's flinch or breath, working trigger points by hand for 60 minutes — is exactly what today's robotics cannot do and language models cannot touch. AI erodes only the periphery: intake forms, SOAP-note drafting, scheduling, marketing copy, and insurance billing. Most states require licensure and clients book a specific therapist by name, which makes the relationship itself the product.",
  "outlook": "Demand keeps growing with an aging population and clinical acceptance of manual therapy; the only real squeeze is on income, not existence, as pay stays tied to hours your hands are on a table.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "Broader state adoption of the FSMTB Model Practice Act plus insurer/payer rules requiring a licensed LMT to be the named provider on billed medical-massage claims (e.g. auto-injury PIP and workers' comp fee schedules that list LMT-only CPT 97124/97140 billing, as in Washington and Florida). If more states move massage from registration to full licensure with personal disciplinary liability and mandatory professional liability coverage, the shield tightens.",
        "plausibility": "plausible",
        "would_add": 4
      },
      {
        "dimension": "trust_premium",
        "change": "Continued substitution of robotic/mechanical massage chairs and devices (Aescape's robotic massage tables now in Equinox clubs, Therabody lounges) for the low-end relaxation tier, leaving named-therapist bodywork explicitly sold as human-delivered — the same split that raised the premium on human-poured coffee and live music. Watch for spas advertising 'human therapist' as a line item at a price gap.",
        "plausibility": "already happening",
        "would_add": 2
      },
      {
        "dimension": "judgment_accountability",
        "change": "Formal integration of LMTs into clinical referral pathways where the therapist owns contraindication screening and red-flag referral decisions — e.g. VA and hospital-based integrative pain programs, and state chiropractic/PT practice acts that let an LMT accept direct-access clients without a physician prescription. Direct access shifts the 'is this safe to treat' call onto the therapist, with board consequences for getting it wrong.",
        "plausibility": "plausible",
        "would_add": 4
      },
      {
        "dimension": "task_resistance",
        "change": "Task-mix shift is limited here: the periphery (notes, billing, scheduling) is a small share of the day and its removal leaves the hands-on hour largely unchanged. Only a genuine move into medical/oncology/prenatal massage specialization, where treatment planning under contraindications becomes a real second tier, would add anything.",
        "plausibility": "plausible",
        "would_add": 1
      }
    ],
    "ceiling_note": "Already at 76 with embodiment maxed; realistic headroom is roughly high-80s. The binding constraint is not AI but economics — median pay, high attrition, and employer control of client relationships in franchise chains (Massage Envy model) mean a booking-app or platform owning the client name is a bigger threat to the trust premium than any robot."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 103300,
        "wage": 39990
      },
      {
        "y": 2018,
        "emp": 105160,
        "wage": 41420
      },
      {
        "y": 2019,
        "emp": 107240,
        "wage": 42820
      },
      {
        "y": 2020,
        "emp": 85040,
        "wage": 43620
      },
      {
        "y": 2021,
        "emp": 81030,
        "wage": 46910
      },
      {
        "y": 2022,
        "emp": 86270,
        "wage": 49860
      },
      {
        "y": 2023,
        "emp": 92650,
        "wage": 55310
      },
      {
        "y": 2024,
        "emp": 96040,
        "wage": 57950
      },
      {
        "y": 2025,
        "emp": 98790,
        "wage": 58450
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": -4.4,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}