This advisory on Medical Spa Services provides guidance to those establishments and practitioners who offer medical procedures and treatments associated with medical spas.

The public has increasingly been seeking dermatologic procedures in establishments that operate under different names, but are commonly referred to as "medical spas." Because of the increasing interest in medical spas, the Department of Public Health (DPH), Division of Health Care Facility Licensure and Certification, is advising medical spas on DPH's clinic licensure requirements.

Medical spas are known by a variety of terms. Medical spas may refer to themselves as, or be part of, medical or beauty clinics, walk-in clinics, spas, salons, health clubs, wellness centers, salon, retail locations or other environments. The licensing requirements described below apply regardless of the name of the enterprise.

Massachusetts law requires that clinics be licensed by the Department of Public Health. (See M.G.L. c. 111, § 51.) A clinic is any entity,however organized, whether conducted for profit or not for profit, that is advertised, announced, established, or maintained for the purpose of providing ambulatory medical, surgical, dental, physical rehabilitation, or mental health services. However, the law provides an exception for any such entity if it is wholly owned and controlled by one or more of its medical practitioners and does not use the word "clinic," "institute" or "dispensary" in its name. (See M.G.L. c. 111, § 52 for the definition of "clinic.") Thus, a medical spa that provides medical services is subject to clinic licensure if it is not wholly owned and controlled by one or more of its practitioners.

The following procedures are examples of medical procedures/treatments that must be performed by or under the direction of, or in some cases under the supervision of, a medical practitioner, and are thereby classified as medical services. The procedures include, but are not limited to, laser/light and radiofrequency devices, chemical peels, soft tissue fillers/augmentation, botulinum toxin, and sclerotherapy. Additionally, "medical services" may include any procedure that uses a biologic or synthetic material, chemical application, mechanical device or displaced energy of any kind. Any business that offers these procedures is subject to clinic licensure unless otherwise exempt.

Clinic Licensure Regulation (105 CMR 140.000)

A medical spa that provides medical services or in which medical procedures are rendered must be licensed by DPH and meet the requirements of 105 CMR 140.000. A medical spa or equivalent establishment that is not currently licensed as a clinic, or a planned medical spa, must complete an application to become a licensed clinic. A medical spa that is part of a licensed clinic that is currently in compliance with 105 CMR 140.00 does not need to apply for additional licensure.

If the medical spa is wholly owned and controlled by one or more of the practitioners who provide its medical services, it does not have to be licensed as a clinic and is therefore exempt from the requirements of 105 CMR 140.000. However, the practice itself is still subject to oversight by the licensing board appropriate to the practitioner providing the service.

Regulation by Other Agencies

The Board of Registration in Medicine regulates the practice of medicine. Please refer to its website at www.massmedboard.org for information on procedures that it regulates as the practice of medicine and other requirements.

The Board of Registration in Nursing regulates the practice of nursing. Please enter its website through www.mass.gov/dph/boards for information and requirements for procedures that may be performed by nurses independently or under the supervision of a physician.

The Board of Registration in Physician Assistants regulates physician assistants. Please enter its website through www.mass.gov/dph/boards for information and requirements for physician assistants.

The Board of Registration of Cosmetologists regulates cosmetologists. Please enter its website through the Division of Professional Licensure.

Please also be aware that Chapter 81 of the Acts of 2006 established a task force within the Board of Registration in Medicine to study medical spas. Task force materials are available at the Board's website at www.massmedboard.org . DPH will update this advisory as necessary to reflect any changes as a result of task force recommendations.

Applications

All proposals and applications for clinic licensure should be submitted to:

David Brown
Department of Public Health
Division of Health Care Facility Licensure and Certification
99 Chauncy Street
Boston, MA 02111

Contacts

Clinic License Applications and Proposals:

If you need an application and/or have questions about clinic license applications, please contact David Brown at David.Brown@dph.state.ma.us or 617-753-8115.

The Medical Spa Task Force:

If you have questions about the Medical Spa Task Force, please call Russell Aims at the Board of Registration in Medicine at 617-654-9867.