Is an exam required before a patient can be treated in Texas?
Intake · part of The Practice Perimeter
Short answer
Yes — before any delegated cosmetic procedure a physician, PA, or APRN must establish the practitioner-patient relationship and keep an adequate medical record; the rules require that plus written screening criteria, not a specified hands-on exam.
Before a delegated cosmetic act Texas requires a practitioner-patient relationship to be established — by a physician, or by a PA or APRN acting under the physician’s delegation — and an adequate medical RECORD to be maintained. A physician, PA or APRN must be onsite or immediately available, and at least one person trained in basic life support must be present.
Drawn from 3 verified rules in this section · regulatory monitoring, not legal advice
- 22 TAC §169.26 · Jul 26, 2026
- 22 TAC §169.26 · Jul 26, 2026
- Tex. Occ. Code §111.005(a) · Sep 8, 2026
Related Texas rules
Before a delegated cosmetic act, a practitioner-patient relationship must be established by a physician, or by a PA or APRN acting under the physician’s delegation, and an adequate medical record must be maintained. The identity and title of the person who will perform the act must be disclosed to the patient.
22 TAC §169.26 · verified Jul 26, 2026 · read at Cornell Legal Information Institute
A physician, PA, or APRN must be onsite during the procedure or immediately available for emergency consultation, and at least one person trained in basic life support must be present while the patient is onsite.
22 TAC §169.26 · verified Jul 26, 2026 · read at Cornell Legal Information Institute
How other states answer this
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
Related Texas questions
- Can the pre-treatment exam be done by telehealth in Texas?
- Who may perform the pre-treatment exam in Texas?
- Must someone be on site while a patient is treated in Texas?
- Can a med spa in Texas offer compounded semaglutide or tirzepatide?
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← All Texas rules and changes · 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).