What must the supervising physician actually do in Washington?
Oversight · part of The Practice Perimeter
Short answer
Delegate LLRP treatment only against a written office protocol covering seven points: the authorizing physician; the delegate's activities, criteria and plan; patient selection; devices and settings; device operation, upkeep; complication care; documentation.
A physician may delegate LLRP treatment to a supervised professional whose own scope allows it, but only against a written office protocol carrying seven named elements: the identity of the authorizing physician; the activities, decision criteria and plan the delegate must follow; patient selection criteria; the devices and settings for patients meeting them; how the device is operated and maintained; care and follow-up for complications and emergencies; and the delegate’s documentation and feedback plan.
Wash. Admin. Code 246-919-605(10)(d) · verified Sep 2, 2026 · regulatory monitoring, not legal advice
Related Washington rules
Two further limits close the usual workarounds: a physician performing or delegating nonsurgical cosmetic procedures may not sponsor more than three physician assistants at any one time, and a physician may not permit a delegate to further delegate the procedure to anyone else. Where the physician is unavailable, an alternate must be arranged who is familiar with the protocols in use, accountable for the supervision, and comparably trained.
Wash. Admin. Code 246-919-606(14), (15) and (16) · verified Sep 2, 2026
Using a laser, noncoherent light, intense pulsed light, radiofrequency or plasma device that topically penetrates skin and alters human tissue — an “LLRP device”, and one the FDA classifies as a prescription device — is the practice of medicine under RCW 18.71.011. Washington settles the threshold question in the rule itself rather than leaving it to be argued.
Wash. Admin. Code 246-919-605(1) and (2) · verified Sep 2, 2026
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Related Washington questions
- Does a med spa in Washington need a medical director?
- Who may operate a cosmetic laser in Washington?
- Can a medical assistant give injections in Washington?
- May an esthetician or laser technician perform microneedling in Washington?
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← All Washington 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).