Texas medical director requirements for med spas

Medical-director, supervision, and delegation requirements for aesthetic practices. Below are the Texas rules that govern it, each linked to its primary source. Monitoring and reference, not legal advice.

Physician supervision & delegation in Texas

Cosmetic injections, fillers, and cosmetic laser use are medical acts a physician may delegate under supervision. As of Jan 9, 2025 the governing Board rules are in 22 TAC Chapter 169.

  • A Texas physician may delegate a medical act — including cosmetic injections, dermal fillers, and cosmetic laser use — to a qualified, properly trained person acting under the physician’s supervision, where a reasonable and prudent physician would find it consistent with sound medical judgment. The delegating physician remains responsible for the delegated act.

    Tex. Occ. Code §157.001 · verified Jul 26, 2026

  • The Texas Medical Board classifies nonsurgical medical cosmetic procedures — including the injection of medications or substances for cosmetic purposes and the use of a prescription medical device for cosmetic purposes — as the practice of medicine that may be properly delegated and supervised.

    22 TAC §169.25 · verified Jul 26, 2026

  • The delegating physician must review, approve, or develop a written order for the delegated procedure that identifies the physician, sets patient-screening criteria, describes appropriate care, and provides procedures for handling common complications.

    22 TAC §169.27 · verified Jul 26, 2026

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