At Lengea Law, we are constantly monitoring changes in healthcare law to ensure our clients stay compliant and ahead of regulatory requirements. One area of frequent confusion for medical aesthetics providers in Florida involves the supervision of advanced practice registered nurses (APRNs) and physician assistants (PAs) in offices offering skincare, dermatologic, or aesthetic services.
If you own or operate a med spa or dermatology practice in Florida or have an APRN or PA who provides patient care, it is crucial to understand the specific rules that apply when the supervising physician is not physically present at the office.
The Core Rule: Fla. Stat. 458.348(3)(c)
This law applies when:
- a physician supervises an APRN or PA;
- at a location that is not the physician’s primary practice site;
- the location provides primarily dermatologic or aesthetic skin care services; and
- and the physician is not physically onsite.
This applies even to APRNs who have full practice authority in Florida.
Key Compliance Requirements
To legally operate under these conditions, the physician must meet the following standards:
1. Report the Office Location
The physician must submit the addresses of all non-primary practice locations where they supervise an APRN or PA to the Florida Board of Medicine.
2. Board Certification Requirement
The supervising physician must be board certified or board eligible in dermatology or plastic surgery, as recognized under Section 458.3312.
3. Geographic Limits
The supervised office:
- must be within 25 miles of the physician’s primary practice location; or
- in a contiguous county (i.e., sharing a border with the county of the primary office); and
- the maximum distance between the physician’s primary location and any satellite location may not exceed 75 miles.
4. Limit on Number of Offices
A physician may only supervise one satellite office in addition to their primary practice location.
5. No Chart Cosign Required
Unlike other PA supervision requirements, the physician is not required to review or cosign charts or records prepared by a PA at the satellite aesthetic or dermatologic office.
6. Post a Schedule
A current schedule showing:
- when the physician is physically present in the office; and
- when the office is open without the physician’s present.
These schedules must be conspicuously posted in each office.
Important Exceptions
This subsection does not apply to services provided in the following settings:
- hospitals or facilities licensed under Fla. Stat., Chapter 395;
- colleges of medicine or nursing;
- federally qualified health centers (FQHCs);
- nursing homes, assisted living facilities, and continuing care facilities;
- government-operated clinics; and
- offices where the exclusive service provided is laser hair removal.
Summary for Med Spa Owners
If you are a med spa owner in Florida, where you provide primarily skincare or dermatologic services, here are the requirements you must meet if your supervising physician is not onsite:
- the physician is a board-certified dermatologist or plastic surgeon;
- the office is located close enough to the physician’s primary office (within 25 miles or in a contiguous county, and no more than 75 miles apart);
- you only have one satellite location under this type of supervision;
- you have filed the office address with the Board of Medicine; and
- you have a schedule posted that clearly shows physician-presence hours.
Final Thoughts
These laws were designed to ensure patient safety and accountability in a growing field where non-physicians are delivering increasingly complex care. At Lengea Law, we help our clients set up compliant supervisory and operational structures to reduce risk and support sustainable growth.
If you need help evaluating your practice’s structure or updating your compliance protocols, our experienced healthcare attorneys are here to assist.