How to Open a Med Spa in North Carolina

North Carolina is a great place to open a med spa but unique laws and legal considerations can make the process seem confusing and daunting to entrepreneurs and seasoned industry professionals alike. Although med spa operation in North Carolina comes with many compliance requirements, Lengea is here to help as you launch and run your successful med spa business.
After you’ve come up with a vision for your med spa–space, staff, name, feel, etc.- it’s time to get to work.

Who Can Own A Medical Spa in North Carolina?

The first hurdle that prospective North Carolina med spa owners must navigate is the corporate practice of medicine doctrine (“CPOM”) that prohibits a licensed healthcare provider from co-owning a medical practice with a non-licensed individual. North Carolina regulatory boards frequently enforce the CPOM doctrine, complicating things for business folks wishing to partner with physicians, nurse practitioners, etc., to run a med spa. In North Carolina, only physicians, or a combination of physicians and physician assistants or physicians and nurse practitioners, may own a med spa. Registered nurses may not own a med spa; they can, however, own management services organizations.

What is the MSO Model in North Carolina?

One way around the CPOM issue for individuals who do not meet the criteria for ownership laid out above is the management services organization (“MSO”) model. In this model, a licensed healthcare provider owns the med-spa, and the non-licensed individual owns the MSO. The MSO provides non-clinical management services, such as billing and collection, front-office staffing, vendor contract negotiation, and similar tasks. In exchange, the med-spa pays the MSO a monthly management fee. This gives the MSO a greater degree of control over the business decisions of the med spa and allows the MSO to hold the majority of the value in the medical practice. Recently, however, North Carolina regulators have begun commenting on the use of this model as a workaround and scrutinizing it more closely, so setting up the MSO in compliance with these laws and staying abreast of the changing regulatory landscape is absolutely critical.

What are the Supervision Requirements for Nurses in North Carolina?

North Carolina also has specific supervision requirements as well as scope-of-practice requirements that dictate who may perform various types of procedures and whether such individuals must be directly supervised by a physician or nurse practitioner. Complying with these laws is complex, but Lengea is here to help you navigate and set up operations in a legally sound way.
If you’re interested in starting a medical spa, there is no time like now! The industry is expected to continue its dramatic growth, and you’ll only miss out the longer you wait and the later you get your foot in the door. We hope this guide helps you envision the steps necessary to start your med spa. For any questions regarding starting your medical spa – Lengea is here to help! Book your 15-minute free consultation today!

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Does North Carolina prohibit the corporate practice of medicine?

Yes. North Carolina prohibits the corporate practice of medicine.

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Who may own a medical spa in North Carolina?

In North Carolina, only licensed physicians or a combination of physicians and nurse practitioners or physicians and physician assistants may own medical spas.

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How can non-MDs, PAs or NPs get involved in the medical spa and IV hydration business in North Carolina?

Non-licensed healthcare providers in North Carolina can become involved with a medical spa business using the MSO/MSA structure.

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Does North Carolina charge sales and use taxes on medical spa services?

No. North Carolina does not tax medical spa services.

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Who can perform cosmetic laser services in North Carolina?

In North Carolina, physicians may perform cosmetic laser services (including tattoo removal and hair removal) and may also delegate such services to an unlicensed individual who the physician determines is properly trained and competent to perform such services and who the physician supervises.

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