Medical Spa Laws and Requirements in Texas

While Texas law does not provide a single definition for a medical spa, it is generally considered a licensed healthcare facility offering non-surgical aesthetic treatments. Because the regulatory environment is complex and varies by state, this guide clarifies Texas's rules on ownership, licensing, and supervision to help you operate your clinic with confidence and full compliance.

How Medical Spa Laws Work in Texas

In Texas, a medical spa is a hybrid clinic offering non-invasive cosmetic medical procedures, while a traditional day spa provides non-medical services like facials and massages. This distinction is crucial because any service considered the practice of medicine subjects the facility to specific medical spa laws in Texas. Consequently, your med spa is legally viewed as a medical practice, which dictates who can own a med spa and requires strict med spa compliance.

The primary reason for these med spa regulations is patient safety, as treatments like injectables and laser therapies are medical procedures that carry inherent risks. To ensure high standards of care, several state agencies oversee spas in Texas and define the medical spa requirements Texas. These include the Texas Medical Board, the Texas Department of License and Regulation, and the Texas Department of State Health Services.

Medical Spa Requirements in Texas

To achieve full med spa compliance, you must meet several key medical spa requirements Texas has established. The state’s strict medical spa laws in Texas dictate who can own a med spa, limiting ownership exclusively to licensed physicians due to the Corporate Practice of Medicine doctrine. These med spa regulations also mandate physician supervision over all medical procedures, proper staff credentialing, and securing all necessary business and medical licenses to operate legally.

Medical Spa Ownership & Business Structure Requirements in Texas

The medical spa ownership laws Texas enforces are guided by the state's Corporate Practice of Medicine (CPOM) doctrine. This doctrine dictates that ownership is exclusively for physicians, ensuring medical decisions remain separate from outside business interests. This rule is a key part of the state's med spa regulations, designed to protect the integrity of medical decision-making.

For non-physicians wondering who can open a med spa, the answer involves a Management Services Organization (MSO) structure. Through an MSO, a non-physician can manage the business operations while the physician-owned medical practice handles all clinical services. The medical practice is often a professional limited liability company (PLLC), while the MSO operates as a separate business entity.

Every one of the spas in Texas offering medical services must have a medical director who is a licensed physician. This director must be actively involved, supervising all procedures, establishing signed written protocols, and ensuring all staff are properly trained. Fulfilling these duties is fundamental to meeting the medical spa requirements Texas has established and maintaining full med spa compliance.

Facility, Licensing, and Compliance Requirements in Texas

To open a med spa in Texas, you must secure a medical spa license from the state board of health and obtain local business licenses for tax and zoning compliance. Your facility will also need to pass inspections to receive fire and health department permits. These steps are a core part of the medical spa requirements Texas has in place for all new clinics.

Protecting patient information is a critical part of med spa compliance, making HIPAA certification mandatory for handling health records. Your clinic must also follow state health department rules for sanitation and infection control. The supervising physician is responsible for staff training in procedure techniques, complication management, and infectious disease control.

All spas in Texas offering medical services are required to carry general liability and malpractice insurance to protect against legal claims. Your advertising must also follow specific med spa regulations, such as disclosing physician supervision when promoting services. Finally, proper recordkeeping is essential, requiring you to maintain adequate medical records for every patient.

Who Can Perform Medical Spa Procedures in Texas?

In Texas, procedures like injectables, laser treatments, IV therapy, and microneedling are classified as nonsurgical medical cosmetic procedures, which are legally considered the practice of medicine. This distinction is a core part of the medical spa laws in Texas, separating these treatments from non-medical services like facials that a licensed esthetician can perform. Adhering to these med spa regulations is essential for med spa compliance and patient safety.

The medical spa requirements Texas enforces strictly define who can perform these medical services. Here are the allowed providers and their roles:

• Physicians (MD/DO): Can perform all medical procedures and are the only professionals who can delegate tasks and supervise other providers.
• Physician Assistants (PAs) and Advanced Practice Registered Nurses (APRNs): Can perform medical procedures under the supervision of a licensed physician after the physician issues an order.
• Registered Nurses (RNs): Can perform certain delegated medical procedures, such as administering Botox or performing microneedling, but must be supervised by a physician.
• Estheticians and Medical Assistants: May only perform non-medical cosmetic procedures or assist with administrative tasks and cannot be delegated any medical procedures.

A physician may delegate medical acts but is ultimately responsible for the quality of care and must ensure the provider has received appropriate training. According to Texas Medical Board rules, this training must cover procedure techniques, contraindications, and managing complications. For full compliance, a physician, PA, or APRN must be on-site or immediately available for emergencies during any delegated procedure.

Laser & Energy Device Regulations in Texas

Texas law classifies lasers, IPL, and other energy devices as prescription medical devices, and their use is considered a medical procedure. This classification is a key part of the medical spa laws in Texas, subjecting these treatments to oversight from both the Texas Medical Board and, for certain services like laser hair removal, the Texas Department of License and Regulation. Understanding this framework is fundamental to your med spa compliance.

According to state med spa regulations, a physician must first perform a patient examination and issue an order before any energy device procedure can be performed. While a physician, PA, or APRN can operate these devices, a physician may delegate the task to other qualified and trained individuals. However, one of the core medical spa requirements Texas enforces is that a physician, PA, or APRN must be on-site or immediately available for emergencies during the treatment.

The supervising physician is responsible for ensuring any delegated staff receives appropriate training in procedure techniques, contraindications, complication management, and infection control. While Texas does not have a single registration for all laser technicians, agencies like the TDLR set specific certification requirements for procedures under their purview. The delegating physician remains fully responsible for patient safety and all aspects of the procedure, including the management of any complications.

Medical Spa Enforcement, Penalties & Risk Management in Texas

Failing to adhere to the medical spa laws in Texas can expose your practice to significant legal and financial risks. State agencies, particularly the Texas Medical Board, actively enforce these med spa regulations to protect public safety. Violations can result in severe penalties, including cease-and-desist orders, substantial fines, and disciplinary action against a physician’s license. Understanding these risks is the first step toward building a resilient and compliant practice.

Many enforcement actions arise from common, often unintentional, mistakes. Here are some of the most frequent compliance issues for spas in Texas:

• Improper Delegation: Assigning a medical procedure to an individual who is not qualified or properly supervised under Texas law, such as having an esthetician perform laser treatments.
• Unlicensed Practice of Medicine: This can occur through incorrect business structures that violate the Corporate Practice of Medicine doctrine, which dictates who can own a med spa.
• Inadequate Supervision: Failing to have a physician, PA, or APRN on-site or immediately available during a delegated medical procedure.
• False or Misleading Advertising: Promoting services without clearly disclosing physician oversight or making claims that cannot be substantiated.

Proactive risk management is essential for maintaining med spa compliance and protecting your business. To help you stay ahead of the complex medical spa requirements Texas mandates, we recommend implementing these best practices:

• Conduct Regular Compliance Audits: Periodically review your clinic’s protocols, patient records, and operational procedures to ensure they align with current med spa regulations. This is a critical step, as med spa laws by state can change.
• Prioritize Staff Training and Credentialing: Maintain a detailed log of all staff training, certifications, and licenses. Ensure every team member understands their specific scope of practice.
• Maintain Thorough Documentation: Keep organized records of everything, including physician orders, patient consent forms, delegation protocols, and equipment maintenance logs. Proper documentation is your best defense in an audit.

Stay Compliant with Portrait Care in Texas

Operating a compliant medical spa in Texas requires careful attention to ownership structures, physician supervision, and staff credentialing. By following the state's med spa regulations—from adhering to the Corporate Practice of Medicine doctrine to maintaining thorough documentation—you build a foundation of safety and trust that protects both your patients and your practice. You can learn more about opening a compliant med spa with our comprehensive guide.

This content is for informational purposes only and is not a substitute for professional legal advice. We encourage you to consult with a qualified healthcare attorney to ensure your practice meets all of Texas's legal requirements.

Portrait Care is built to help you manage compliance and grow your practice with confidence. Schedule a demo today to see how our all-in-one platform can support your clinic.