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Medical Aesthetic Laws & Regulations State by State
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AmSpa's legal summaries allow you to quickly reference the laws governing medical spas in your state. They are a list of commonly asked questions researched and prepared for easy use by a team of skilled lawyers at ByrdAdatto Law Firm. ByrdAdatto also offers one free consultation to our members to help guide you with your aesthetic business.

Who can own a med spa?

Who can inject neuromodulators and fillers?

Who can fire a laser?

Are Botox parties legal?

AmSpa Plus

Become a Plus member to see answers for your state to all 103 medical aesthetic legal questions listed below.

AmSpa Basic

Become a Basic member to see answers to 31 select medical aesthetic legal questions for your state.

Ownership and Structure

● (Plus and Basic) What is a med spa and what is considered "the practice of medicine"?

  1. (Plus Exclusive) What procedures are considered the practice of Medicine?

● (Plus and Basic) What is the corporate practice of medicine?

● (Plus and Basic) Who can own a medical spa?

  1. (Plus and Basic) Can a non-physician own all or part of a medical spa?
  2. (Plus and Basic) What is a Management Service Organization (MSO)?
  3. (Plus Exclusive) What type of entity may own a medical spa?

● (Plus and Basic) What are the penalties for improperly owning a medical spa by violating the Corporate Practice of Medicine Doctrine?

● (Plus and Basic) If I’m not a doctor, can I employ a “medical director” to provide medical services for my medical spa?

  1. (Plus and Basic) As a non-doctor, can I share in the profits of a medical spa?
  2. (Plus and Basic) As a person without a medical license, how can I make money from a medical spa?

● (Plus and Basic) Can a chiropractor or dentist serve as a medical director?

● (Plus Exclusive) In a medical spa, what decisions have to be made by a doctor?

● (Plus Exclusive) In a medical spa, who can make hiring and firing decisions?

● (Plus Exclusive) Can anyone other than a licensed physician use the initials M.D.?

● (Plus Exclusive) Do I have to be a doctor to own medical spa equipment, like lasers, or real estate?

● (Plus and Basic) Can a nurse, physician assistant or nurse practitioner take a commission for administering a medical treatment?


Providers

● (Plus and Basic) What is a physician assistant? What is a physician assistant's scope of practice?

  1. (Plus and Basic) What is the scope of practice of a physician assistant in a med spa?
  2. (Plus Exclusive) Do physicians have to be physically present when a PA is performing services in a medical spa?

● (Plus and Basic) What is a nurse practitioner? What is a nurse practitioner’s scope of practice?

  1. (Plus Exclusive) Does a physician have to be physically present while a nurse practitioner is performing services in a medical spa?

● (Plus and Basic) Does a physician have to examine every new patient before the patient is treated at a med spa?

  1. (Plus and Basic) What about nurse practitioners and physician assistants? Can they see new patients or must a physician do it?
  2. (Plus Exclusive) Are there special written requirements for any orders or patient charts for physician assistants?
  3. (Plus Exclusive) Can a PA perform cosmetic procedures such as operate lasers, inject Botox, and perform micro dermabrasion?
  4. (Plus Exclusive) Can a PA hand pre-packaged medication to patients?

● (Plus and Basic) What is a registered nurse or a licensed vocational nurse?

  1. (Plus and Basic) What is the scope of practice for a nurse or LVN?
  2. (Plus and Basic) Are there special written requirements for any orders or patient charts for physician assistants?
  3. (Plus and Basic) What kind of physician supervision is needed for a registered nurse (RN) in a medical spa?

● (Plus and Basic) What is a medical assistant? What role do they play in a medical spa?

  1. (Plus and Basic) Should a medical assistant be licensed to practice in this state?
  2. (Plus Exclusive) What is the legal scope of medical assistants in this state?
  3. (Plus Exclusive) Should a medical assistant disclose, while working, his or her name and the practitioner’s license status on a nametag?
  4. (Plus Exclusive) May medical assistants perform any procedure in a medical spa so long as they are properly supervised?
  5. (Plus Exclusive) Are medical assistants allowed to pierce the skin?
  6. (Plus Exclusive) Are medical assistants allowed to administer Botox or inject collagen?
  7. (Plus Exclusive) Are medical assistants allowed to use lasers or intense light devices to remove hair, scars,moles or other blemishes?

● (Plus and Basic) When is a physician-patient relationship needed? How is it established? Is a physician-patient relationship established by a consultation?

● (Plus and Basic) What is informed consent?

  1. (Plus and Basic) Do all medical procedures require informed consent?
  2. (Plus Exclusive) What information must a physician disclose to satisfy informed consent?

● (Plus Exclusive) What type of records are medical spas required to keep of their patients?

  1. (Plus Exclusive) How long must a medical spa retain medical records?
  2. (Plus Exclusive) Must a medical spa provide a copy of a patient’s medical records if requested by the patient?
  3. (Plus Exclusive) Does a patient have a right to access their medical information?

● (Plus Exclusive) What is a DEA Registration Number?


Treatments

● (Plus and Basic) Who can legally fire a laser in my state?

  1. (Plus Exclusive) Does a physician need to be on site during a laser procedure?
  2. (Plus Exclusive) Can a registered nurse use a laser or intense pulse light device in a medical spa?
  3. (Plus Exclusive) What are laser technicians and can they operate lasers under proper supervision?
  4. (Plus Exclusive) Can an aesthetician, cosmetologist, electrologist or vocational nurses use lasers or intense light devices?

● (Plus and Basic) Who can legally inject Botox/fillers/needless injections?

  1. (Plus Exclusive) Are Botox parties legal?

● (Plus Exclusive) Who can legally perform the following treatments:

  1. (Plus Exclusive) Microneedling and PRP/PRF
  2. (Plus Exclusive) Light-emitting Devices
  3. (Plus Exclusive) Dermaplaning
  4. (Plus Exclusive) Cryolipolysis (Coolsculpting)
  5. (Plus Exclusive) Permanent Makeup/Microblading?
  6. (Plus Exclusive) Microdermabrasion
  7. (Plus Exclusive) Energy based skin tightening: Radio frequency devices; Fibroblast
  8. (Plus Exclusive) PDO Threads
  9. (Plus Exclusive) IV Treatments

● (Plus and Basic) Can an aesthetician or non-licensed professional perform microneedling, dermaplaning, microblading or microdermabrasion?

● (Plus and Basic) Can a med spa hire an aesthetician to perform nonmedical dermabrasion, cosmetic facial and skin treatments?

● (Plus Exclusive) What regulations affect new and trending procedures?


Business Operations

● (Plus and Basic) What is OSHA and does it apply to medical spas?

  1. (Plus and Basic) What are some of the key responsibilities under OSHA for med spas?
  2. (Plus Exclusive) What’s the most frequently cited OSHA violation in medical spas?
  3. (Plus Exclusive) Are lasers subject to OSHA requirements?

● (Plus and Basic) What is the FDA and what do they do?

● (Plus and Basic) Does a medical spa need to obtain a license to operate?

● (Plus and Basic) What is HIPAA?

  1. (Plus Exclusive) What is the HITECH Act?
  2. (Plus Exclusive) Who is a “covered entity” under HIPAA?
  3. (Plus Exclusive) What administrative requirements are provided in the HIPAA Security and Privacy Rules?
  4. (Plus Exclusive) Should a medical spa provide patients with a notice that includes how their health information will be used, and of the patient’s rights regarding their health information?
  5. (Plus Exclusive) What are the requirements to distribute a Notice of Privacy Practices to patients?
  6. (Plus Exclusive) Must a med spa make efforts to limit the use or disclosure of a patient’s PHI?

● (Plus and Basic) Does my state have its own version of HIPAA? How does it differ?

● (Plus Exclusive) I don’t accept insurance so am I still subject to HIPAA requirements?

● (Plus Exclusive) What are some of the safety measures that apply when handling needles/sharps?

● (Plus Exclusive) What are the common employer defenses to an allegation of a workplace violation?

● (Plus Exclusive) How often must a medical spa review and update their exposure control plan?

● (Plus Exclusive) Can a physician use a picture album containing patient photos?

● (Plus Exclusive) May a physician leave a message on a patient’s answering machine? Verify an appointment with a family member or spouse?

● (Plus Exclusive) Can a med spa text or email patients to convey confidential medical information?

● (Plus Exclusive) If a patient posted a message or a review on a medical spa’s social media page, can and how should the medical spa respond?

● (Plus Exclusive) May a med spa use a sign in sheet, or call out names of patients in the waiting room?

● (Plus Exclusive) Is it legal to purchase drugs like Botox and fillers from overseas? From Canada, Europe, or Asia?

● (Plus Exclusive) Can medical spas sell retail products i.e. skin creams?

● (Plus Exclusive) Can staff take commissions on non-medical retail products?

● (Plus Exclusive) Do medical spas have to charge sales tax on retail products?

● (Plus Exclusive) Do I need to charge sales tax on procedures like Botox?

● (Plus Exclusive) Can a medical spa practice under a fictitious name or a "dba"?

  1. (Plus Members Only) Which agency is responsible for fictitious name permits?
  2. (Plus Members Only) What are some of the requirements to receive a fictitious name permit?
  3. (Plus Members Only) Once the fictitious name permit is granted, must the physician also file for a fictitious name with their local county and city agencies?

● (Plus Exclusive) Can a medical spa require patients to sign an arbitration agreement as a condition for providing medical care?


Marketing Your Med Spa

● (Plus Exclusive) Can a medical spa advertise its professional services?

  1. (Plus Exclusive) How should a medical practice advertise its prices?
  2. (Plus Exclusive) Can a medical spa include testimonials and endorsements by actual patients or models in its advertising?
  3. (Plus Exclusive) Does a physician have to use his or her name in advertisements?

● (Plus Exclusive) I’ve heard that providing gift cards or reward programs in exchange for referrals is a “kickback.” Is this true? What are kickbacks?

  1. (Plus Exclusive) What are the anti-kickback statutes?
  2. (Plus Exclusive) What are some examples of prohibited kickbacks and referral arrangements?
  3. (Plus Exclusive) How do I properly incentivize my staff and patients to bring my med spa more business without engaging in kickbacks?

● (Plus Exclusive) Can a medical spa pay a person or entity to market the practice’s services?

● (Plus Exclusive) Can a medical spa offer discounts through Groupon or other similar social networking websites?

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Member Resources

AmSpa offers live webinars and over 100 recordings featuring the leading brands and thought leaders in the industry covering topics on medical aesthetic law, business processes, marketing, and treatment trends. 
AmSpa Plus
AmSpa Plus members can watch all live webinars for free, and have unlimited free access to the full recorded webinar library.

AmSpa Basic
AmSpa Basic members can watch all live webinars for free. Basic Members can also watch recorded webinars for a reduced member rate.
The Lounge brings together hundreds of medical aesthetic professionals to share notes and trade advice every single day.
AmSpa Unlimited
AmSpa Unlimited members can join the AmSpa Member Lounge on Facebook with 6 additional employees.

AmSpa Plus
AmSpa Plus members can join the AmSpa Member Lounge on Facebook with 3 additional employees.

AmSpa Basic
AmSpa Basic members can join the AmSpa Member Lounge.
AmSpa's legal summaries allow you to quickly reference the laws governing medical spas in your state. They are a list of commonly asked questions researched and prepared for easy use by a team of skilled lawyers at ByrdAdatto Law Firm.
AmSpa Plus
AmSpa Plus members have access to all 103 legal questions for their state or the District of Columbia. Contact us for multi-state access.

AmSpa Basic
AmSpa Basic members have access to 31 select legal questions for their state or the District of Columbia.
This online reference tool clarifies Who Can Do What in your state, covering 21 different treatments across 6 distinct professional titles.
AmSpa Plus
AmSpa Plus members have access to the Treatment Delegation Table for their state or the District of Columbia. Contact us for multi-state access.

AmSpa Basic
Sign up for AmSpa Plus to access your state's Treatment Delegation Table.
The 2019 Medical Spa State of the Industry Report provides business, operations, staffing, and legal statistics and analysis of one of the fastest growing industries in the United States, fast approaching a total value of $10 billion. If you're looking for data on medical spas and non-invasive medical aesthetics, look no further.
AmSpa Plus
AmSpa Plus members can download the full 2019 State of the Industry Report.

AmSpa Basic
AmSpa Basic members can download the executive summary of the 2019 State of the Industry Report. Sign up for AmSpa Plus to download the full document.
The AmSpa Masters Online Training Program brings years of medical spa experience directly to your screen. From techniques and treatments to legal and business best-practices, this on-demand program is your medical spa master class.
AmSpa Plus
AmSpa Plus members receive significantly reduced member pricing on live and recorded AmSpa Masters courses and the Virtual Boot Camp.

AmSpa Basic
AmSpa Basic members receive reduced member pricing on live and recorded AmSpa Masters courses and the Virtual Boot Camp.
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byrdadatto

AmSpa's legal summaries are powered by ByrdAdatto, a business and healthcare law firm with an aesthetics practice that spans the United States. If you need additional legal counsel for any matters concerning your medical spa or medical aesthetic practice contact ByrdAdatto.

"I use ByrdAdatto for all of my practice and medical spa needs. They are the go-to aesthetic attorneys in the United States."

-W. Grant Stevens
CEO of Marina Plastic Surgery Associates


Disclaimer: The information and answers contained in these frequently asked questions provide a general guide to certain laws that apply to "medical spas" in this particular state. The information on this site is for general reference only and accuracy cannot be guaranteed, as medical spa legalities and regulations change very frequently. This information is not intended to provide legal advice, and it should not be relied upon as legal advice. This information is not intended to create, and receipt of it does not constitute, an attorney-client relationship. Readers: You should not act upon this information without seeking knowledgeable legal counsel that takes the laws of your jurisdiction into account. All uses of the content of this site, other than personal uses, are prohibited.

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AmSpa provides legal, compliance, and business resources for medical spas and medical aesthetic practices.

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