Last reviewed November 4, 2026. We checked each legal point below against Tennessee statutes, administrative rules and state board websites, and removed points we could not confirm. Rules change often, so confirm with your state licensing board or a healthcare attorney before you rely on them.
Author: Allyson Avila, Esq.
Who can own a medical spa?
A Tennessee state licensed physician or a physician group practice can own a medical spa in Tennessee. Tennessee law does not allow a business entity to practice medicine (Tenn. Code Ann. § 68-11-205(a)). Tennessee Code Title 48, Chapter 101, Part 6 Section 48-101-610 provides that the following health care professionals shall have a right to form and own shares in the same professional corporation:
- Optometrists licensed under title 63, chapter 8, and ophthalmologists licensed under title 63, chapter 6 or 9;
- Podiatrists licensed under title 63, chapter 3, and physicians licensed under title 63, chapter 6 or 9, except radiologists, pathologists, or anesthesiologists;
- Doctors of chiropractic licensed under title 63, chapter 4, and physicians licensed under title 63, chapter 6 or 9, except radiologists, pathologists, and anesthesiologists; and
- Physician assistants licensed under title 63, chapter 19, part 1, and physicians licensed under title 63, chapter 6 or 9, except radiologists, pathologists, and anesthesiologists.
Can a non-physician own all or part of a medical spa?
Not through a professional corporation. Under Tenn. Code Ann. § 48-101-610(a)(2), a professional corporation may issue shares to people not licensed to practice the profession in Tennessee only if the licensing authority for those professionals specifically authorizes it.
If I’m not a doctor or a licensed practitioner, how can I make money from a medical spa?
There are certain contracts that, if properly formed, will permit the non-physician to share in certain revenues of the medical spa. Tenn. Code Ann. § 63-6-225(b) allows a physician to pay an independent contractor that provides goods or services a percentage of the physician's fees, if the percentage is reasonably related to the value of the goods or services provided. It is essential that the agreements must be properly formed by an experienced attorney to ensure that the agreements do not violate Tennessee’s laws regarding the corporate practice of medicine and fee splitting.
If I’m not a doctor, can I employ a “medical director” to provide medical services for my medical spa?
No. Tennessee law does not allow a person or corporation to practice medicine. The exception for employers is narrow: an entity may employ a physician to treat only its own employees, retirees, or their dependents (Tenn. Code Ann. § 68-11-205(a) and § 63-6-204).
Can a nurse, physician assistant or nurse practitioner take a commission for administering laser treatments or injectables like Botox?
Tennessee Code 63-6-225 governs when a physician may share fees, including percentage-based pay:
- (a) It is an offense for any licensed physician or surgeon to divide or to agree to divide any fee or compensation of any sort received or charged in the practice of medicine or surgery with any person without the knowledge and consent of the person paying the fee or compensation or against whom the fee may be charged.
- (b) This section does not prohibit a physician from compensating any independent contractor that provides goods or services to the physician on the basis of a percentage of the physician's fees generated in the practice of medicine. The percentage paid must be reasonably related to the value of the goods or services provided. Payments by physicians in return for referrals are prohibited.
Do I need to charge sales tax on procedures like Botox?
Drugs purchased under a prescription are exempt from Tennessee sales and use tax (Tenn. Code Ann. § 67-6-320). We recommend that you consult with your certified public accountant about how this exemption applies to procedures like Botox.
What type of insurance does a medical spa need?
A medical spa should have a malpractice policy covering any provider that performs medical services, a general liability policy and a product liability policy covering any equipment used and retail goods sold. The spa or practice should also have employment practices liability insurance and cyber security insurance.
Can a medical spa pay a person or entity to market the practice’s services?
A physician may pay an independent contractor, such as a marketer, a percentage of the physician's fees if the percentage is reasonably related to the value of the goods or services provided. Payments by physicians in return for referrals are prohibited (Tenn. Code Ann. § 63-6-225(b)).
What type of information must a medical spa post?
Under Tenn. Code Ann. § 63-1-153, any entity doing business as or advertised as a medical spa shall display the name of the medical director or supervising physician and shall indicate by signage at its practice site and in its media and advertising whether they are board certified, board eligible, or not certified.
Which procedures at medical spas constitute medical treatment?
Under Tennessee law, a cosmetic medical service is any service that uses biological or synthetic material, a chemical application, a mechanical device, or a displaced energy form of any kind that alters or damages or is capable of altering or damaging living tissue to improve the patient’s appearance or achieve an enhanced aesthetic result.
Who can perform lasers treatments?
Any procedure within the definition of the practice of medicine in Tenn. Code Ann. § 63-6-204 that is performed with a laser is the practice of medicine, except as provided in Tenn. Code Ann. §§ 63-26-102(5) and 63-9-106. Anyone performing such a procedure must be under the supervision of a licensed physician (Board of Medical Examiners medical spa FAQ). See also our laser hair removal training for physicians.
What type of training is needed?
To receive an electrologist license from the state of Tennessee, you must have a high school diploma or equivalent and have completed a 600 hour course of instruction in electrology (175 Theory and 425 Clinical practice).
Can a physician assistant practice independently?
No.
Collaboration Requirements
Tenn. Code Ann. § 63-19-106 states that a PA may perform selected medical services only in collaboration with a licensed physician. Collaboration requires active and continuous overview of the PA's activities, but not the constant physical presence of the collaborating physician. The Board of Medical Examiners and the Board of Physician Assistants adopt rules on the collaborating physician's review of the charts of patients examined by the PA.
Prescriptive Authority for Physician Assistants
Under Tenn. Code Ann. § 63-19-107, a collaborating physician may delegate authority to prescribe controlled substances to a PA, with added limits on Schedule II, III and IV controlled substances.
Can an advanced practice registered nurse practice independently?
No. Under Tenn. Code Ann. § 63-7-123, an NP with a certificate of fitness to prescribe must file a notice with the Board of Nursing naming the licensed physician collaborating with the NP. That physician has control and responsibility for the NP's prescriptive services.
What is a medical assistant? What role do they play in a medical spa?
Medical assistants are professional multi-skilled persons dedicated to assisting in all aspects of medical practice under the direct supervision and responsibility of a physician. This practitioner assists with patient care management, executes administrative and clinical procedures, and often performs managerial and supervisory functions.
Can a dentist inject Botox?
The Tennessee Board of Dentistry's rules list Botox injections and future FDA-approved neurotoxins among the procedures included in the dental practice of oral and maxillofacial surgery. A licensee who performs them without the qualifications the rule requires is subject to discipline (Tenn. Comp. R. & Regs. 0460-02-.06).
Can a med spa hire an aesthetician to perform nonmedical dermabrasion, cosmetic facial and skin treatments?
Yes, Physicians can hire licensed individuals to perform cosmetology services, if they have obtained a license from the State of Tennessee.
What about nurse practitioners and physician assistants? Can they see new patients or must a physician do it?
Yes as long as it is agreed to in the practice agreement with the supervising physician an NP or PA may see new patients.
Does a medical spa need to obtain a license to operate?
Yes. Pursuant to Public Chapter 494, which was signed by Governor Haslam on May 20th, 2015, the Board of Medical Examiners and the Board of Osteopathic Examination are required to establish and maintain an online registry for "medical spas." A "medical spa" is any entity, however named or organized, which offers or performs "cosmetic medical services." A "cosmetic medical service" is any service that uses a biologic or synthetic material, a chemical application, a mechanical device, or a displaced energy form of any kind that alters or damages, or is capable of altering or damaging, living tissue to improve the patient's appearance or achieve an enhanced aesthetic result.
If you are a medical director or supervising physician of a medical spa, you must register your medical spa by completing the registration form and submitting it to your licensing Board as soon as possible.
All registrations must be renewed annually and will be subject to an annual registration fee.
Must I follow OSHA regulations?
Yes. Every business in the United States must know the OSHA regulations and have policies and procedures in place to comply with the regulations. This includes a bloodborne pathogen policy, a contaminated needlestick policy and a laser safety policy with the appointment of a laser safety officer.
What type of records are medical spas required to keep of their patients?
Tennessee requires that medical spas or facilities keep your name, address, telephone number or other contact information. Your date of birth or medical record number. Date(s) of treatment or service (such as dates you were in the hospital).
How long do I have to keep the patient’s records?
Under the Board of Medical Examiners rules, medical records must be kept for at least ten years from the physician's or supervisee's last professional contact with the patient. Records of minors must be kept for at least one year after the minor reaches the age of majority or ten years from the last professional contact, whichever is longer (Tenn. Comp. R. & Regs. 0880-02-.15).
Are Botox parties legal?
No. The Board of Medical Examiners' medical spa FAQ says pop-up parties and door-to-door concierge services are not allowed. All medical spa services must be performed at the practice site, which is the address on the medical spa registration.
What is HIPAA?
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is federal law that aims to protect patient privacy while improving the efficiency and effectiveness in the health care system by requiring standards and requirements for any electronic transmission of protected health information (PHI). Its rules relate to privacy and security, notifying patients if his or her personal information was breached, and sets uniform standards for electronic transmissions and transactions.
Does Tennessee have its own version of HIPAA? How does it differ?
Tenn. Code Ann. § 47-18-2107 is not a state version of HIPAA. It is Tennessee's data breach notice law, and it does not apply to an information holder that is subject to HIPAA (§ 47-18-2107(i)).
What is a DEA Registration Number?
A DEA registration number is a number assigned to a health care provider by the U.S. Drug Enforcement Administration that allows them to write prescriptions for controlled substances.
What is the FDA and what do they do?
The FDA is a regulatory agency that protects the public health by ensuring, among other things, that prescription and non-prescription drugs, vaccines, biological products, medical devices and electronic products that give off radiation (lasers) are safe and effective.
Can a chiropractor or dentist serve as a medical director?
No. A medical spa's medical director must be a medical doctor or osteopathic physician with an active Tennessee license and an active medical practice in Tennessee.
See also: business courses for med spa owners. Disclaimer: The information and answers contained in these frequently asked questions provide a general guide to certain laws that apply to "medical spas" and cosmetic medical treatment in this particular state. The information on this site is for general reference only and accuracy cannot be guaranteed, as medical spa legalities and regulations change very frequently. This information is not intended to provide legal advice, and it should not be relied upon as legal advice. This information is not intended to create, and receipt of it does not constitute, an attorney-client relationship. Readers: You should not act upon this information without seeking knowledgeable legal counsel that takes the laws of your jurisdiction into account. All uses of the content of this site, other than personal uses, are prohibited.
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Keep reading with what states allow estheticians to do injections, can an RN open a med spa, can an NP open a med spa, Pennsylvania medical spa regulations, New Jersey medical spa regulations, New Hampshire medical spa regulations and Idaho medical spa regulations.
