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Laws Regarding IV Therapy in Medical Spas

Posted By Administration, Monday, June 4, 2018

Intravenous therapy (or IV therapy) is a medical spa treatment that is growing throughout the country, so questions about the law are starting to come in more and more frequently. It has been around in hospitals and medical practices for decades as a means to quickly provide an infusion of fluids and medicines to patients, however with the growth of non-invasive medical aesthetic practices, more business are attempting to offer quick, alternative ways of improving an individual’s health, look and feel.

As such, IV Bars are a growing trend, allowing individuals quick access to hangover treatments via IV hydration with an infusion of vitamins and nutrients. Additionally, some of these facilities offer ongoing treatment to promote anti-aging and revitalization.

What many owners of these facilities do not realize is that the piercing of skin via the IV is the practice of medicine in many states, including Texas. While these procedures are commonly referred to as “cosmetic treatments,” under Texas law, all procedures that involve the injection of medication or substances for cosmetic purposes are considered medical procedures. In fact, Texas law designates them “nonsurgical medical cosmetic procedures.” As such, this limits the ownership of an IV Bar to only a select number of licensed medical providers in many states due to the corporate practice of medicine doctrine, and the supervision requirements over those providing medical services.

Corporate Practice of Medicine

The first major legal consideration is the prohibition against the “corporate practice of medicine.” This is a rule many states have adopted that prohibits lay people or lay entities from employing physicians or offering professional medical services. States that have strong corporate practice of medicine rules include Texas and California. These states, along with several others, explicitly provide that providing the types of non-invasive, elective procedures that an IV Bar does entails the practice of medicine. As a result, this prohibition must be taken into account when setting up an IV Bar.

(AmSpa members can check their state's medical aesthetics legal summary to see if their state's laws regarding the corporate practice of medicine.)

Find answers to your med spa law questions, with AmSpa's State Legal Summaries.
Click Here


The second major consideration in establishing and owning an IV Bar is proper supervision. Each state delineates who can provide certain types of medical services, which in Texas, includes IV Bar services. For example, every state generally requires that only licensed physicians perform surgery on a patient, but not all states specifically outline what kind of licensing and training is required for someone to provide elective non-invasive services. However, the Texas Administrative Code (“TAC”), Section 193.17, “Nonsurgical Medical Cosmetic Procedures” does provide additional guidance on supervision and training for Texas-based medical facilities. Based on this rule, IV Bars must follow the same supervision requirements set forth in the TAC.

(For more info on supervision and delegation in medical spas, watch AmSpa’s Medical Spa Webinar on the topic)

Based on the above limitations, those non-physicians, wishing to enter into the nonsurgical cosmetic treatments need to make sure they understand the limitations and develop corporate models that are legal under state laws.

Bradford Adatto is a partner at the business, healthcare, and aesthetic law firm of ByrdAdatto. He has worked with physicians, physician groups, and other medical service providers in developing ambulatory surgical centers, in-office and freestanding ancillary service facilities, and other medical joint ventures. He regularly counsels clients with respect to federal and state health care regulations that impact investments, transactions, and contract terms, including Medicare fraud and abuse, anti-trust, anti-kickback, anti-referral, and private securities laws.

For more information and guidance on setting up IV Bars or staffing an IV Bar please contact Brad at or (214) 291-3201.

Tags:  Med Spa Law 

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Comments on this post...

William Brown III says...
Posted Tuesday, June 5, 2018
I understand the points about owning the IV therapy service, but could you please comment on which level of provider is authorized to physically start the IV and administer the fluids/vitamins. In general does it have to be a nurse bc of the “medicine” being administered or can it be a paramedic (I know it varies by state). Also does the MD have to be onsite while clients come in and select their treatments? If it’s considered the practice of medicine does that mean the clients need a face to face consult/exam prior to getting a treatment?
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micah gibbs says...
Posted Sunday, August 26, 2018
I am wondering the same thing, as RN, and Future FNP working to open a medical/dermatolgy spa with IV Therapy Services, does this only require and RN and FNP or does it have to be a MD?
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