Who Can Own or Open a Medical Spa?
Last Updated on 10 December, 2025
Opening a medical spa and offering treatments like injectables, lasers, or other advanced cosmetic procedures sounds exciting. But it also raises a question many prospective owners overlook: Who can legally own or open a medical spa?
Laws vary widely across the U.S., and understanding them before you plan a business is essential.
In this post, we’ll cover who can open a med spa, the key legal requirements, different ownership models (including the MSO route), and which medical or non-medical professionals can legally own or co-own a med spa.
Key takeaways: Who can open a medical spa
- Ownership rules depend heavily on the state you’re in and whether the state enforces the “corporate practice of medicine.”
- In many states, only licensed physicians (MD/DO) can open a medical spa.
- Non-physicians, including nurse practitioners (NP), physician assistants (PA), registered nurses (RN), or entrepreneurs without a clinical license, may only own via special structures (e.g., an MSO) or as minority/co-owners.
- Estheticians/cosmetologists generally cannot directly own a medical spa that offers medical-grade services.
- If you’re a non-physician, compliance demands strict separation of business vs. medical operations and involvement of a licensed medical director.
This guide covers:
- What are the legal requirements to own a medical spa in the U.S.?
- Types of med spa ownership models in the U.S.
- What is the MSO (management services organisation) model?
- Who can own a medical spa: medical vs. non-medical professionals?
- Can an esthetician open or own a medical spa legally?
- Can a physician assistant open or co-own a med spa?
- Can a registered nurse open or own a med spa without a physician?
- What are the risks of unqualified ownership in the med spa industry?
- Conclusion: Who can own or open a med spa legally?
- ❓ FAQs about who can open a medical spa ❓
What are the legal requirements to own a medical spa in the U.S.?
Because a medical spa offers medically regulated services, legal structure matters as much as clinical qualifications. Who owns the business (and how) directly impacts liability, compliance, and what services you can legally offer.
Federal vs. state regulation
There is no single federal law that regulates med spa ownership. Instead, most regulations arise from state laws, especially through doctrines like the Corporate Practice of Medicine (CPOM).
Under CPOM, many states restrict medical practice ownership to licensed physicians or physician-owned entities, to ensure medical decision-making remains in the hands of qualified professionals.
However, not all states have strict CPOM enforcement. In those states, non-physicians, including businesses run by non-medical entrepreneurs, can own med spas so long as licensed professionals perform the medical services.
See this Corporate Practice of Medicine 50-State Guide to learn more about what each state requires.
The MSO model
One common workaround for non-medical owners is the Management Services Organisation (MSO) model. This separates business/administrative functions from clinical services.
The MSO handles operations, marketing, and staffing under the business side, while a licensed physician retains control over clinical and medical decisions.
That way, the business stays compliant with state laws that restrict non-medical ownership of medical practices.
Types of med spa ownership models in the U.S.
Ownership in the med spa world isn’t one-size-fits-all. Because every state draws its own line between who can practice medicine and who can run the business behind it, different ownership structures have emerged to keep clinics compliant.
Here are the most common med spa ownership models in the U.S.
| Ownership Model | Who Can Own? | Legal Considerations |
| Direct Physician Ownership | Licensed Physicians | Full legal control, high liability |
| MSO Partnership | Non-physician + Physician | Shared business control, strict legal separation required |
| Corporate Ownership (varies) | Healthcare Companies | Subject to CPOM, often regulated heavily |
| Franchise or Licensing Model | Entrepreneurs + Medical Directors | Needs legal vetting, liability often shared |
What is the MSO (management services organisation) model?
What is an MSO?
An MSO is a business entity that provides non-clinical services (like administration, staffing, billing, and marketing) to a medical spa. The clinical services and medical decisions remain with a licensed physician or medical-license holder.
How does an MSO work in a med spa setting?
Through an MSO, a non-medical entrepreneur can handle business operations, day-to-day management, client experience, marketing, and more — while the clinical side remains under the control of a physician. That way, the venture stays compliant with state laws that restrict non-medical ownership of medical practices.
Advantages of the MSO model
- Enables non-physicians to invest in or run the business side of a med spa.
- Keeps medical decision-making and liability with licensed clinical staff.
- Allows clearer separation of clinical vs. business operations, reducing compliance risk.
Risks of the MSO model
- Must maintain strict legal separation. Commingling business decisions with medical decisions can breach compliance.
- Requires a licensed, actively participating medical director (not a “doctor on paper”).
- Depending on state law, some MSO arrangements may still be restricted or scrutinised heavily.
If you’re running a med spa through an MSO, your systems matter just as much as your structure. WellnessLiving’s Medical Spa Software gives owners an easy, compliant way to manage scheduling, marketing, payments, and client records while keeping clinical decision-making where it belongs—with licensed medical staff.
Who can own a medical spa: medical vs. non-medical professionals?
Understanding the difference between “medical professionals” and “non-medical professionals” is critical. Medical spas straddle both medical and cosmetic domains, and ownership rights shift accordingly.
Here’s a breakdown by role:
Who can legally own a med spa?
Below, you’ll find a guide that breaks down who can legally own a med spa by role, conditions required, and ownership type.
* Please note that laws vary by state and local jurisdiction. It’s best to consult a healthcare attorney or state licensing board before assuming any given ownership path is legal.
| Role | Can Own Med Spa? | Conditions Required | Ownership Type |
| MD/DO (Physician) | Yes | Must be licensed in the state | Direct |
| Nurse Practitioner (NP) | Sometimes | Depends on state practice authority | Direct/Co-Ownership |
| Physician Assistant (PA) | Sometimes | Co-ownership allowed with MD in some states | Co-Ownership |
| Registered Nurse (RN) | Rarely | Needs MSO + physician partnership | MSO Only |
| Esthetician/Cosmetologist | No | Can only own wellness spa, not medical spa | MSO (Non-medical) |
| Entrepreneur (Non-medical) | No | Must use MSO and hire licensed medical director | MSO Only |
Licensed physicians (MD/DO) remain the most straightforward path to full ownership. Some non-physician clinicians (like NPs or PAs) may qualify depending on their state’s laws.
Others (like RNs, estheticians, or non-medical entrepreneurs) usually have to rely on an MSO structure, and even then cannot steer the clinical side.
Related Post: What License Do You Need to Open a Medical Spa? [US & Canada]
Can an esthetician open or own a medical spa legally?
Estheticians often want to expand their services into the medical aesthetics world, but ownership laws don’t always make that easy. Medical procedures trigger stricter regulations, and that affects what estheticians can and cannot do legally.
Here’s what you need to know.
Why estheticians usually cannot directly own med spas
In many states, the moment you offer injectables, lasers, or anything considered a medical procedure, your med spa falls under the same rules as a medical practice. That usually means only physicians or licensed medical professionals can legally own it.
Estheticians, whose licenses cover cosmetic and wellness services (not medical ones) can’t control the clinical side. Where state law allows, they may still join the business through a separate management entity, but only with a properly licensed medical provider involved.
Exceptions
In some states without strict CPOM enforcement (Florida, Alaska, Arizona, Michigan, to name a few), an esthetician or entrepreneur can form or own an MSO. This lets them handle the business side (marketing, bookings, administration), while a licensed physician retains all clinical control.
This structure allows participation without violating medical-ownership laws.
How estheticians can still thrive in the med spa space
Even without owning the clinical practice, estheticians can manage or own the non-medical side: spa atmosphere, client experience, skin care (non-medical), wellness services. With a compliant MSO + physician oversight, they can still play a valuable operational role.
Can a physician assistant open or co-own a med spa?
Physician assistants (PAs) are trained medical professionals, but their authority to operate independently varies significantly by state. When it comes to med spa ownership, the rules aren’t always straightforward.
This section breaks down when PAs can legally own or co-own a med spa, and where their involvement is restricted.
- What is a physician assistant’s legal scope? PAs are medically trained, but unlike physicians (MD/DO), their independent ownership rights vary widely by state. They often must operate under a supervising physician or within scope-of-practice laws.
- States that allow PA co-ownership. Some states (e.g., Texas) do allow PAs to co-own a med spa, but they are typically minority partners alongside a physician, with a physician handling the medical oversight. See this article on “Jointly Owned Entities – Physician and Physician Assistant” by the Texas Medical Board for more information.
- States where PA ownership is restricted. In states with strict CPOM enforcement (e.g., Illinois and California), PAs are prohibited from owning a med spa, even in partnership. That means a licensed physician must own and control the clinical side.
- The MSO option for PAs. As with other non-physicians, in restrictive states, a PA might participate in business operations via an MSO, but they cannot claim full ownership of the medical practice or control clinical decisions.
Can a registered nurse open or own a med spa without a physician?
Registered nurses (RNs) play a major role in medical aesthetics, but ownership laws place clear limits on how far they can go without physician involvement. Before an RN considers opening a med spa, it’s important to understand what state regulations allow, what they prohibit, and where the MSO model may offer a path forward.
What are a registered nurse’s legal limits?
RNs do not have the same license privileges as physicians, physician assistants, or nurse practitioners. In states with CPOM enforcement, RNs are typically not permitted to own or control medical practices.
Are there any exceptions?
In states with less restrictive laws, there may be allowance for non-physician ownership, but even then, RNs rarely qualify without collaboration with a physician and often only through an MSO.
The MSO model: A legal path for RNs
If an RN wants to play an ownership or operational role, participation through an MSO (with licensed physician oversight) could be the only compliant route.
What are the risks of unqualified ownership in the med spa industry?
Entering the med spa business without proper licensing or legal structure carries serious risks. And they’re not just legal penalties, but also client safety and liability.
Some dangers:
- Operating in violation of CPOM laws can lead to lawsuits, fines, or forced closure.
- Medical liability if an unlicensed owner tries to influence or perform clinical decisions.
- Regulatory scrutiny, reputational damage, and loss of trust if procedures are delegated incorrectly.
- Difficulty obtaining insurance or banking support for non-compliant business structures.
One way to reduce operational and documentation errors is by using tools designed specifically for regulated wellness environments. WellnessLiving’s Medical Spa Software helps ensure proper client intake, treatment notes, consent forms, and record-keeping, critical pieces of staying compliant in a medical-grade setting.
Conclusion: Who can own or open a med spa legally?
There’s no one-size-fits-all answer here. Ownership depends on your state’s regulations, the licenses you hold, and how you structure the business.
The simplest, most compliant path remains direct ownership by a licensed physician.
Non-physicians (from NPs to entrepreneurs) can sometimes participate, but often only via an MSO or co-ownership with a physician. If you’re considering entering the med spa space, it’s vital to consult a healthcare attorney experienced in your state’s laws and to ensure a licensed medical director is involved.
Need a partner that will make opening a med spa as easy a possible? Book a free, no-commitment consultation with WellnessLiving today!
❓ FAQs about who can open a medical spa ❓
In a few states with relaxed ownership laws, non-doctors can own a med spa, provided a licensed professional performs all medical services. In states enforcing corporate practice of medicine, non-medical owners must rely on an MSO and partner with a physician.
Costs vary widely depending on location, licensing, equipment, lease, staffing, and whether you need to hire a medical director. Beyond start-up costs, budgeting for compliance, insurance, and legal consultation is critical.
Wellness or beauty spas that avoid medical-grade procedures (e.g. basic skincare, massage, non-invasive cosmetic treatments) typically have less stringent ownership requirements. Medical spas offering injectables, lasers, or other regulated services face stricter oversight, which often demands licensed medical professionals and compliance with CPOM or equivalent laws.
Licensed physicians remain the most common and legally stable owners. In states with flexible laws, some nurse practitioners and physician assistants co-own or run med spas. Non-medical entrepreneurs sometimes succeed too, but only when paired with a compliant MSO structure and physician oversight.
