Can a management company run the business side of a med spa, state by state
The same question, answered for 7 states from each state’s own law. States disagree on this, which is the point — an answer that is right in one is wrong next door. Every entry below is a statute or board rule we verified, most recently Sep 3, 2026.
Ownership · part of The Practice Perimeter
| State | What its rule says | Cited to |
|---|---|---|
| California | A percentage-of-revenue management fee is lawful in California where it is commensurate with value — and unlawful where it is not. | Cal. Bus. & Prof. Code § 650(b) Sep 2, 2026 |
| Connecticut | The cited rules do not settle this — none address management companies. A professional corporation may use unlicensed clerks and bookkeepers, and out-of-state licensees who control a CT licensee's judgment can't be its shareholder, director or officer. | Conn. Gen. Stat. §33-182c(c) Sep 3, 2026 |
| Indiana | “An employment or other contractual relationship between an entity described in subsection (a)(21) through (a)(22) and a licensed physician does not constitute the unlawful practice of medicine or osteopathic medicine under this article if the entity does not direct or control independent medical acts, decisions,… | Ind. Code §25-22.5-1-2(c) Jul 26, 2026 |
| Massachusetts | The cited rules do not settle this — they say nothing about management contracts, only that a majority of a professional corporation's directors and all officers except treasurer, clerk and secretary must be licensed, and that shares may go only to licensees. | Mass. Gen. Laws ch. 156A, § 9 Sep 1, 2026 |
| New York | The cited rules don't settle the structure — they limit the pay: a lay management company isn't among those who may share professional fees, and any charge for space, equipment or staff tied to the practice's receipts is misconduct for the physician. | N.Y. Educ. Law § 6530(19) Sep 2, 2026 |
| Tennessee | The cited rules do not settle this — none addresses management companies; they only bar non-physician ownership of a medical professional corporation, exempt its charter from Board filing, and make rebates on treatment fees a discipline ground. | Tenn. Comp. R. & Regs. 0880-02-.20(1)(a) Sep 2, 2026 |
| Texas | Yes — but only the non-clinical side: even a Board-certified physician organization may not interfere with, control, or direct a physician's professional judgment, and an unlicensed company cannot employ physicians in a way that controls medical judgment. | Tex. Occ. Code §162.0021 Jul 26, 2026 |
Every state, in its own words
California
⚠️ AND THIS IS THE MSO PERCENTAGE-FEE QUESTION ANSWERED IN A SENTENCE. “The payment or receipt of consideration for SERVICES OTHER THAN THE REFERRAL OF PATIENTS that is BASED ON A PERCENTAGE OF GROSS REVENUE OR SIMILAR TYPE OF CONTRACTUAL ARRANGEMENT SHALL NOT BE UNLAWFUL IF THE CONSIDERATION IS COMMENSURATE WITH THE VALUE OF THE SERVICES FURNISHED OR WITH THE FAIR RENTAL VALUE OF ANY PREMISES OR EQUIPMENT LEASED OR PROVIDED” by the recipient to the payer. A percentage-of-revenue management fee is lawful in California where it is commensurate with value — and unlawful where it is not.
Cal. Bus. & Prof. Code § 650(b) · verified Sep 2, 2026 · read at Public.Law — California Codes
The full California answer, with the rest of the section → · Every California rule on ownership & corporate practice of medicine →Connecticut
Persons licensed to render the same professional services in another jurisdiction shall not be shareholders, directors or officers of a professional corporation if such persons unlawfully practice their profession in this state, or direct or control any person licensed to practice such profession in this state concerning the delivery of professional services or the exercise of professional judgment.
Conn. Gen. Stat. §33-182c(c) · verified Sep 3, 2026
The full Connecticut answer, with the rest of the section → · Every Connecticut rule on ownership & corporate practice of medicine →Indiana
INDIANA’S EMPLOYMENT SAFE HARBOR IS NOT GENERAL — IT NAMES THE ENTITIES IT COVERS, AND A LAY-OWNED COMPANY IS NOT ONE OF THEM. “An employment or other contractual relationship between an entity described in subsection (a)(21) through (a)(22) and a licensed physician does not constitute the unlawful practice of medicine or osteopathic medicine under this article if the entity does not direct or control independent medical acts, decisions, or judgment of the licensed physician.” Subsection (a)(21) is “A hospital licensed under IC 16-21 or IC 12-25”, and (a)(22) is “A health care organization whose members, shareholders, or partners are individuals, partnerships, corporations, facilities, or institutions licensed or legally authorized by this state to provide health care or professional services as” a physician, a psychiatric hospital, a hospital, a health maintenance organization, a health facility, a dentist, a registered or licensed practical nurse, a midwife, an optometrist, a podiatrist, a chiropractor, a physical therapist or a psychologist. The no-control condition is a SECOND requirement on those entities, not a route for any other kind of owner.
Ind. Code §25-22.5-1-2(c) · verified Jul 26, 2026
The full Indiana answer, with the rest of the section → · Every Indiana rule on ownership & corporate practice of medicine →Massachusetts
The board and the officers are licensed too, with a named exception: a MAJORITY of the directors of a professional corporation, and ALL of its officers except the treasurer, clerk, secretary and their assistants, shall be licensed in the commonwealth to render a professional service permitted by the articles of organization. The exception is precisely the administrative offices — the clinical direction is not among them.
Mass. Gen. Laws ch. 156A, § 9 · verified Sep 1, 2026
The full Massachusetts answer, with the rest of the section → · Every Massachusetts rule on ownership & corporate practice of medicine →New York
⚠️ AND THE STATUTE NAMES THE MSO STRUCTURE BY ITS MECHANICS. “THIS PROHIBITION SHALL INCLUDE ANY ARRANGEMENT OR AGREEMENT WHEREBY THE AMOUNT RECEIVED IN PAYMENT FOR FURNISHING SPACE, FACILITIES, EQUIPMENT OR PERSONNEL SERVICES USED BY A LICENSEE CONSTITUTES A PERCENTAGE OF, OR IS OTHERWISE DEPENDENT UPON, THE INCOME OR RECEIPTS OF THE LICENSEE FROM SUCH PRACTICE.” Percentage rent, a percentage staffing fee and a percentage management fee are the three things a med spa MSO usually charges, and this sentence reaches all three by their form.
N.Y. Educ. Law § 6530(19) · verified Sep 2, 2026
The full New York answer, with the rest of the section → · Every New York rule on ownership & corporate practice of medicine →Tennessee
One piece of administrative relief worth knowing: a Medical Professional Corporation NEED NOT file its Charter or its Annual Statement of Qualifications with the Board. The entity is governed by Title 48 chapter 101 part 6; the Board regulates the physicians inside it rather than the paperwork of the company.
Tenn. Comp. R. & Regs. 0880-02-.20(1)(a) · verified Sep 2, 2026
The full Tennessee answer, with the rest of the section → · Every Tennessee rule on ownership & corporate practice of medicine →Texas
Even a certified organization may not interfere with, control, or otherwise direct a physician’s professional judgment.
Tex. Occ. Code §162.0021 · verified Jul 26, 2026
The full Texas answer, with the rest of the section → · Every Texas rule on ownership & corporate practice of medicine →Which states this covers
7 of the 51 states for which we publish statute-cited rules. That is not every state, and nothing above should be read as describing one that is not listed — the answer genuinely differs, so a neighbouring state is not a guide. We monitor all 50 state legislatures plus the FDA and the Federal Register daily; the cited rule set is narrower than the monitoring and is growing on its own timetable.
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