Does a med spa have to register or hold a license in Montana?

Short answer
Not directly — Montana issues no med spa-specific license, and the medical chapter licenses only physicians and residents, not facilities. But a place where esthetics is practiced for compensation must hold a salon or shop license.

Montana licenses the practitioner and, on the cosmetology side, the premises. a salon or shop where esthetics is practiced needs a license from the department and may not house another business outside the board’s scopes of practice unless that area is separated by a full-length partition. The Board of Barbers and Cosmetologists sets the fees in a rule, in dollars: $100 for a practitioner license, $125 for a salon or shop license, $150 for a salon or shop inspection, and $95 for a booth rental license. The Board of Medical Examiners’ physician license application fee is $375, and a physician assistant’s is $375. A practitioner who wants to dispense drugs to the practitioner’s own patients must register with the Board of Pharmacy, dispense only at the practitioner’s office or place of practice, only to the practitioner’s own patients, with an offer of counseling, and only drugs necessary to the treatment; the registration is $240 with a $150 annual renewal, and a registrant who compounds must do so under the pharmacy compounding rule. A medical practitioner other than a pharmacist may not own a community pharmacy, and that prohibition does not stop a practitioner dispensing a drug the dispensing statute permits; the rebate ban is not carved out that way — no medical practitioner may solicit or knowingly receive a rebate, refund, discount, commission, or other valuable consideration from a community pharmacy based on drug sales to the practitioner’s patients.