Owning and opening a med spa in California

What this site covers, and where to begin

In California a med spa that offers injectables or lasers is a medical practice, and nearly every rule on this site follows from that one fact.

That is why the ownership question comes before the lease, the laser purchase or the brand. Start with who can own a med spa if you are still working out whether your plan is legal at all, and with the opening sequence if the ownership is settled and you want the order of the filings.

Ownership, medical directors and management companies

The practice itself must be owned by physicians, with a minority share open to certain other licensees and none at all to a lay investor.

Two arrangements are sold as ways around that. The first is a lay-owned spa hiring a doctor as a paid medical director, which the Medical Board treats as unlicensed practice; the medical director page explains why. The second is a management services organization, which can be legitimate if it stays on the business side of the line; the MSO page sets out where that line sits.

The entity, the filings and who can file them

The clinical practice is usually a professional medical corporation, because a California LLC cannot render professional services at all.

The entity comparison covers the medical corporation, the management LLC and the sole practitioner route side by side. The setup guide walks through every filing in order, and the fictitious name permit guide covers the Medical Board permit a practice needs before it can trade under a spa name. The formation-services page lists what each service publishes about its own prices, and which of them will file a professional corporation at all.

Who may treat, and how you may advertise

Injections and lasers are limited to physicians and to nurses and physician assistants working under physician supervision, after a prior examination the practice has to document.

Estheticians and medical assistants have narrower lanes than many spas assume. Who can perform treatments covers each role, and the advertising rules cover the price, photo and naming restrictions that apply to a physician practice and that catch spa-style marketing most often.

What it costs to open and to keep running

The state filing fees are small; the recurring obligations are what a new owner tends to underestimate.

The startup cost breakdown lists every published state fee in one table. Taxes and annual filings covers the $800 minimum franchise tax, the Statement of Information and the permit renewals, and insurance and workplace safety covers workers' compensation and the bloodborne pathogens plan any injecting practice needs.

Who is allowed to own a med spa?

• Who can own a med spa in California — California requires physician ownership of any med spa offering medical treatments. What the 51/49 split allows, and who is shut out entirely.
• Medical director arrangements for California med spas — Why a lay-owned California med spa cannot fix its ownership by hiring a medical director, and what real physician supervision requires instead.
• Management services organizations for med spas — How a lay founder can own the business side of a California med spa through a management company, and which controls cross the line.

How do I open one, and in what order?

• How to open a med spa in California, in order — The order to settle ownership, form the medical corporation, get the fictitious name permit, and set up supervision before a California med spa opens.
• Setting up a California med spa business, step by step — Every filing to set up a California med spa: the medical corporation, the optional management LLC, the permits, the EIN and the first-year taxes.
• The Medical Board fictitious name permit for med spas — When a California med spa needs a Medical Board fictitious name permit, what it costs, how long it takes, and how the renewal cycle works.

Which entity, and who files it?

• Choosing an entity for a California med spa — Medical corporation, management LLC, or sole practice: how each California structure fits a med spa, and why an ordinary LLC cannot hold the practice.
• Formation services for California med spas compared — Which formation services file a California professional medical corporation, what each publishes as its price, and the Secretary of State's own fee.

Who may do the treatments?

• Who can perform med spa treatments in California — Which California licensees may inject neurotoxin and filler or run medical lasers, who must examine the patient first, and what estheticians may not do.
• Advertising rules for California med spas — What California's physician advertising law bans in med spa marketing: price phrases, unlabeled models, before-and-after images and superiority claims.

What does it cost to run?

• What it costs to open a med spa in California — Every published California state fee to open a med spa, from the $100 professional corporation filing to the $800 minimum tax, in one table.
• Annual taxes and filings for a California med spa — The recurring California obligations of a med spa: the $800 minimum tax, Statements of Information, permit renewals and sales tax on retail products.
• Insurance and workplace safety for California med spas — Workers' compensation, the Cal/OSHA bloodborne pathogens plan, hepatitis B vaccination and sharps logs: what a California med spa must have in place.

Questions