Who must be the responsible practitioner for a med spa, state by state
The same question, answered for 5 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. Each entry links to its own statute or board rule and dated source check. Latest individual source check: Sep 8, 2026.
Facility · part of The Practice Perimeter
| State | What its rule says | Cited to |
|---|---|---|
| Georgia | A consulting physician — a non-physician-office facility doing cosmetic laser services other than hair removal must contract with one who examines each patient first (or delegates that exam to a PA or APRN laser practitioner) and file details with the Board. | Ga. Comp. R. & Regs. 360-35-.07 Aug 17, 2026 |
| Indiana | A physician, a qualifying APRN, or a PA with delegated prescriptive authority, with relevant training and enough physical presence to ensure compliance; the spa's registration must name them and their collaborating/supervising physician. | Ind. Code §25-22.5-12.5-3 (SEA 282, 2026) Jul 26, 2026 |
| Iowa | The title is defined by conduct, not appointment: “Medical director” means a physician who assumes the role of, or holds oneself out as, medical director at a medical spa. | Iowa Admin. Code r. 481—655.6(1), (2), (7) (definition and exceptions — “medical director”) Sep 8, 2026 |
| Tennessee | A medical doctor or osteopathic physician holding an active Tennessee license and an active Tennessee medical practice — that medical director or supervising physician must report their details to the Board, ensure annual registration, and meet signage rules. | Tenn. Comp. R. & Regs. 0880-02-.24(3) and (4) Sep 2, 2026 |
| Texas | A physician — the delegating physician stays responsible for delegated cosmetic acts and must approve the written order, with a physician, PA, or APRN onsite or immediately available; a laser hair removal facility needs a written consulting-physician contract. | Tex. Health & Safety Code §401.519 Aug 17, 2026 |
Every state, in its own words
Georgia
Except for physician offices, a facility providing cosmetic laser services OTHER THAN hair removal using lasers or pulsed light devices must hold an agreement with a consulting physician who examines each patient before the service (or who has delegated that examination to a physician assistant in an approved job description, or to an advanced practice registered nurse under a Board-approved protocol, in either case one who is a licensed cosmetic laser practitioner); must have that physician available for emergency consultation with anyone the facility employs; and must file the physician’s details with the Board.
Ga. Comp. R. & Regs. 360-35-.07 · verified Aug 17, 2026
The full Georgia answer, with the rest of the section →Indiana
Beginning January 1, 2027, a medical spa must be registered to do business in Indiana; the board must establish the registration procedure by October 1, 2026, and the application must identify the responsible practitioner and their collaborating/supervising physician. The board may fine an unregistered operator up to $5,000.
Ind. Code §25-22.5-12.5-3 (SEA 282, 2026) · verified Jul 26, 2026
The full Indiana answer, with the rest of the section →Iowa
The title is defined by conduct, not appointment: “Medical director” means a physician who assumes the role of, or holds oneself out as, medical director at a medical spa. The medical director is responsible for implementing policies and procedures to ensure quality patient care and for the delegation and supervision of medical aesthetic services performed by qualified licensed or certified nonphysician persons or qualified laser technicians at a medical spa, and is ultimately responsible for all medical aesthetic services they perform there. A nonphysician licensed health professional may serve as medical director under that professional’s own licensing authority, and the rule does not reach physicians who direct licensed medical facilities, clinics or practices providing medical aesthetic services incident to their other medical services.
Iowa Admin. Code r. 481—655.6(1), (2), (7) (definition and exceptions — “medical director”) · verified Sep 8, 2026
The full Iowa answer, with the rest of the section →Tennessee
The duty sits on a named person. The medical director or supervising physician responsible for the spa must provide the Board with that information, ENSURE THE ANNUAL REGISTRATION, and comply with the signage and advertisement requirements of T.C.A. § 63-1-153. They must also be a medical doctor or osteopathic physician holding an ACTIVE TENNESSEE LICENSE AND AN ACTIVE MEDICAL PRACTICE IN TENNESSEE — an out-of-state or non-practicing physician cannot fill the role.
Tenn. Comp. R. & Regs. 0880-02-.24(3) and (4) · verified Sep 2, 2026
The full Tennessee answer, with the rest of the section →Texas
A laser hair removal facility must hold a written contract with a consulting physician to establish the protocols for the services it provides and to audit those protocols and the facility’s operations. The facility must document that contractual relationship with the department, and the consulting physician must be available for emergency consultation as the circumstances require.
Tex. Health & Safety Code §401.519 · verified Aug 17, 2026
The full Texas answer, with the rest of the section →Which states this covers
5 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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MedSpaRadar is regulatory monitoring and reference: it summarizes public laws, regulations and agency actions and links each to its source. It is not legal, medical, or compliance advice, and using it creates no attorney-client relationship. A summary can lag its source or leave out detail, and monitoring itself can be interrupted — so an absence of alerts means nothing reached you, not that nothing happened. Read the cited source, check its effective date, and confirm any change to your operations or clinical practice with qualified health-law counsel and your medical director. Legislative data via LegiScan (CC BY 4.0).