Iowa medical director requirements for med spas

Physician supervision & delegation in Iowa

⛔ IOWA WROTE A RULE FOR THE MEDICAL DIRECTOR AT A MEDICAL SPA, AND IT COUNTS IN HOURS, MILES AND PERCENTAGES. 481—655.6 requires the medical director to hold an active unrestricted Iowa license to supervise EACH delegated service, to ENSURE that the people performing delegated services receive direct, in-person, ON-SITE supervision AT LEAST FOUR HOURS EACH WEEK — from the director or another qualified licensed physician or qualified supervising nonphysician professional — and that it is documented, to review on site each week and read AT LEAST 10 PERCENT OF PATIENT CHARTS, and to be physically located WITHIN 60 MILES of where the delegated services are performed AT ALL TIMES. A medical aesthetic service may only be performed by a qualified licensed or certified nonphysician person or a qualified laser technician where the medical director has delegated it, and the director remains ultimately responsible for all of it.

• A medical aesthetic service shall only be performed by qualified licensed or certified nonphysician persons or qualified laser technicians if the service has been delegated by a medical director who is responsible for supervision of the services performed at a medical spa in Iowa.

  Iowa Admin. Code r. 481—655.6(2) (Delegation by a medical director) · verified Sep 4, 2026

• A medical director at a medical spa shall: a. Hold an active unrestricted Iowa medical license to supervise each delegated medical aesthetic service; b. Possess the appropriate education, training, experience and competence to safely supervise each delegated medical aesthetic service; c. Retain responsibility for the supervision of each medical aesthetic service performed by qualified licensed or certified nonphysician persons or qualified laser technicians;

  Iowa Admin. Code r. 481—655.6(3) (Medical director) · verified Sep 4, 2026

• Ensure that all qualified licensed or certified nonphysician persons or qualified laser technicians receive direct, in-person, on-site supervision from the medical director or other qualified licensed physician or other qualified supervising nonphysician licensed health professional at least four hours each week and that the regular supervision is documented;

  Iowa Admin. Code r. 481—655.6(5)(c) (Supervision) · verified Sep 4, 2026

• Provide on-site review of medical aesthetic services performed by qualified licensed or certified nonphysician persons or qualified laser technicians each week and review at least 10 percent of patient charts for medical aesthetic services performed by qualified licensed or certified nonphysician persons or qualified laser technicians;

  Iowa Admin. Code r. 481—655.6(5)(d) (Supervision) · verified Sep 4, 2026

• Be physically located, at all times, within 60 miles of the location where delegated medical aesthetic services are performed;

  Iowa Admin. Code r. 481—655.6(5)(e) (Supervision) · verified Sep 4, 2026

• “Qualified laser technician” means any person, licensed or unlicensed, who has successfully completed a minimum of 120 hours of training, including a minimum of 40 hours of didactic study and 80 hours of clinical training, in the safe and effective use of lasers in the performance of medical aesthetic services at an accredited laser training program. For the purposes of this rule, a qualified laser technician may only use lasers in the performance of delegated medical aesthetic services under the supervision of a qualified supervising physician at a medical spa. An unlicensed qualified laser technician may not perform any other medical aesthetic services defined in this rule.

  Iowa Admin. Code r. 481—655.6(1) (definition of “Qualified laser technician”) · verified Sep 4, 2026

• Develop and implement protocols for responding to emergencies or other injuries suffered by persons receiving delegated medical aesthetic services performed by qualified licensed or certified nonphysician persons or qualified laser technicians;

  Iowa Admin. Code r. 481—655.6(5)(h) (Supervision — emergency protocols) · verified Sep 4, 2026

• A physician with an active permanent, special, or temporary Iowa license who is actively engaged in the practice of medicine in Iowa may supervise a physician associate.

  Iowa Admin. Code r. 481—659.1 (Physician supervision of a physician associate) · verified Sep 4, 2026

Recent Iowa changes

• IA HSB591: A bill for an act establishing the medical spa oversight Act, and making penalties applicable.Jan 20, 2026