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Texas Med Spa Compliance Update: What Changes on September 1, 2025—and How to Get Ready

  • Writer: Christina Garcia
    Christina Garcia
  • Aug 14
  • 7 min read

If you own or operate a medical spa, IV clinic, or aesthetics practice in Texas, September 1, 2025 brings meaningful legal changes—especially for elective IV therapy and laser hair removal. Below is a plain‑English briefing and a practical prep checklist you can put to work today.



At‑a‑Glance: What’s New and What Isn’t


  • New law for elective IV therapy (HB 3749, “Jenifer’s Law”). Sets who can order and administer elective IV therapy outside a physician office or licensed facility, and how delegation must work. Effective September 1, 2025. (Texas Legislature Online)


  • Laser hair removal statute tweaked (SB 748). A technical change to the Health & Safety Code takes effect September 1, 2025 and is already prompting a comprehensive TDLR rule rewrite for Chapter 118 (Laser Hair Removal). Watch for finalized rules. (Texas Legislature Online, Texas Licensing, Texas Secretary of State)


  • Telehealth/telemedicine records (HB 1700). New requirements for records tied to telemedicine/telehealth services (including virtual good‑faith exams) take effect September 1, 2025. Update your policies and EMR workflows. (Texas Legislature Online)


  • The “Botox Party Bill” (SB 378) did not become law. It passed both chambers but was vetoed June 2, 2025—so there’s no new statute from SB 378 on who may inject. Existing Texas Medical Board rules still govern delegation and supervision. (LegiScan, Texas Legislative Reference Library)


  • Reminder: Earlier in 2025, the Texas Medical Board (TMB) reorganized and strengthened its delegation/med‑spa rules under 22 TAC Chapter 169—including posting the delegating physician’s name/license number and name‑badge requirements for staff. These rules remain in force. (Texas Secretary of State, Legal Information Institute)



1) Elective IV Therapy: What HB 3749 Actually Requires


What counts as “elective IV therapy”?A procedure to infuse fluids/nutrients/medications/blood into a vein, sought by the patient to relieve temporary discomfort or improve temporary wellness, when performed outside a physician’s office or licensed facility. (Think mobile IV, wellness IV bars, and med spas.) (Texas Legislature Online)


Who may order IV therapy?A physician may delegate ordering/prescribing to a PA or APRN under adequate physician supervision (RN is not authorized to order). This delegation is under Chapter 157 of the Occupations Code. (Texas Legislature Online)


Who may administer IV therapy?A PA, APRN, or RN may administer under adequate physician supervision. Notably, LVNs, EMTs/paramedics, and MAs are not listed among the roles the statute allows for administration in elective IV settings. (Texas Legislature Online)


Prescriptive Authority Agreement (PAA) cap matters here.If you delegate IV ordering to APRNs/PAs via a PAA, those agreements count toward the physician’s cap (generally seven APRNs/PAs, full‑time equivalent). HB 3749 removes the “facility‑based/underserved area” exception for elective IV therapy, so you cannot use that carve‑out to exceed the cap just for IV businesses. (Texas Legislature Online, Texas Municipal Bureau)


What to do now (IV therapy):

  • Map your workflow. Identify who is ordering IVs (physician vs APRN/PA) and who is administering (PA/APRN/RN only). Reassign any tasks currently performed by LVNs, EMTs, or MAs. (Texas Legislature Online)


  • Audit your PAAs. Count current APRN/PA agreements toward the seven‑delegate cap and confirm annual reviews/signatures are current. (Texas Municipal Bureau)


  • Tighten protocols. Ensure written protocols cover screening (contraindications), dosing, complications, and escalation pathways consistent with TMB’s Chapter 169 standards for delegated acts. (Legal Information Institute)


  • Training & readiness. Verify BLS/IV‑skills competency for every administering clinician; maintain emergency kit and transfer plans. (These are common expectations under TMB delegation standards.) (Legal Information Institute)



2) Laser Hair Removal: SB 748 + New TDLR Rules You’ll Need to Follow


What the statute did.Effective September 1, 2025, SB 748 makes a narrow change to Subchapter M (Laser Hair Removal) of the Health & Safety Code—updating administrative wording and repealing subsections (b) and (c) of §401.516 (the parts that required the licensing commission to specify the size/content/design of the mandatory warning sign and include the design standards with license applications/renewals). (LegiScan, Texas Legislature Online, Justia Law)


Why you’ll still feel it:TDLR flagged SB 748 and has proposed a comprehensive re‑write of 16 TAC Chapter 118 (Laser Hair Removal), including updated facility responsibilities, consulting‑physician protocols, continuing education, records‑retention, fees, and an enforcement subchapter. Watch the Texas Register and TDLR site for the final adopted rules and effective dates. (Texas Licensing, Texas Secretary of State)


What to do now (LHR):

  • Keep posting your warning signs and following the current rules until TDLR adopts the new ones. (SB 748’s repeal targets rule‑making directives about sign design; it doesn’t eliminate the duty to post a warning sign.) (Justia Law)

  • Confirm your consulting‑physician contract and protocols are current and documented with TDLR as required by Subchapter M. (Texas Statutes)

  • Track TDLR’s adoption timeline and be ready to update policies on CE, records, fees, and audits once final text is published. (Texas Secretary of State)



3) Telemedicine/Telehealth Records: HB 1700


If your good‑faith exams or follow‑ups are performed via telemedicine/telehealth, HB 1700 (effective September 1, 2025) creates new record requirements for health professionals providing telemedicine, teledentistry, or telehealth services. Action item: update your telehealth policy and EMR templates (what gets documented, how it’s stored, and for how long) to align with the new statute. (Texas Legislature Online)



4) What Will Not Change on 9/1/25: SB 378 (the “Botox Party Bill”)


You likely saw headlines about SB 378. It aimed to bar cosmetologists/barbers from injections and certain device use and to give TDLR enforcement tools. It was vetoed on June 2, 2025—so no new statute took effect from that bill. Your north star remains the TMB’s Chapter 169 delegation framework: nonsurgical medical cosmetic procedures are the practice of medicine and must be properly delegated and supervised. (LegiScan, Texas Legislative Reference Library, Legal Information Institute)



5) Don’t Forget: TMB Rules You Should Already Be Following


In January 2025, TMB reorganized rules and clarified standards under 22 TAC Chapter 169 (replacing the old §193.17). Key takeaways for med spas:

  • Post these in public areas and each treatment room:

    1. TMB complaint notice; and 2) the delegating physician’s name and Texas medical license number.

    2. Ensure every team member performing a delegated act wears clear name/credential identification. (Texas Secretary of State)

  • Nonsurgical cosmetic procedures (e.g., injections; prescription devices for cosmetic use) remain delegated medical acts with specific standards for protocols, training, supervision, and emergency planning. (Legal Information Institute)



September 1, 2025 Readiness Checklist (print & use)


Elective IV Therapy (HB 3749)

  • ☐ We identified who orders IV therapy (MD/DO or APRN/PA under a PAA) and who administers (PA/APRN/RN only). (Texas Legislature Online)

  • ☐ Our Prescriptive Authority Agreements are current, counted toward the seven‑delegate cap, and reviewed/signed annually. (Texas Municipal Bureau)

  • ☐ Written protocols cover screening, dosing, complications, and escalation; staff are BLS‑trained and IV‑competent. (Legal Information Institute)


Laser Hair Removal (SB 748 + TDLR rules)

  • ☐ Warning signs are posted and compliant (pending any updated TDLR specs). (Justia Law)

  • ☐ Our consulting‑physician agreement and LHR protocols are on file and current. (Texas Statutes)

  • ☐ We’re tracking TDLR’s Chapter 118 rule adoption and ready to update policies on CE, records, and fees. (Texas Secretary of State)


Telehealth/Telemedicine (HB 1700)

  • ☐ Our telehealth policy and EMR templates meet new record requirements for virtual services. (Texas Legislature Online)


Core TMB Requirements (Chapter 169)

  • ☐ Posting: Delegating physician’s name + license number and TMB complaint notice in public areas and treatment rooms.

  • ☐ Identification: Every person performing delegated acts wears a name badge showing name & credentials.

  • ☐ Protocols & training: Documented delegation, supervision level, and emergency procedures for each service and device. (Texas Secretary of State, Legal Information Institute)



Frequently Asked Questions


Can an RN “order” an IV under the new law?

No. HB 3749 allows physicians to delegate the act of ordering/prescribing only to an APRN or PA (under adequate supervision). RNs can administer but cannot order elective IV therapy. (Texas Legislature Online)


We used an EMT to start IVs—can we continue?

Not in elective IV settings governed by HB 3749. The statute lists PA, APRN, or RN for administration; unlisted roles (e.g., EMT/paramedic, LVN, MA) are not authorized for administration in this context. (Texas Legislature Online)


Do we have to change our laser hair removal signage on 9/1/25?

Keep your warning signs posted as you do now. SB 748 repeals the old rule‑making directives about sign design, and TDLR has proposed broader Chapter 118 updates—watch for the final adopted text and effective dates before changing signage. (Justia Law, Texas Secretary of State)


Did Texas restrict who can inject Botox on 9/1/25?

No new statute did. SB 378 (the highly publicized “Botox Party Bill”) was vetoed. Delegation and supervision continue to be governed by TMB Chapter 169. (LegiScan, Texas Legislative Reference Library, Legal Information Institute)



Final Word & How We Can Help


Texas is tightening clarity around elective IV therapy, reorganizing laser hair removal rules, and sharpening expectations for telehealth documentation—all while the TMB’s Chapter 169 delegation framework remains the anchor for med‑spa compliance. If you need help updating your Standing Delegation Orders, prescriptive‑authority agreements, staff training, signage, or protocols, The Aesthetic Compliance Co. offers tailored, state‑specific support—so you can focus on delivering safe, high‑quality aesthetic care.


Compliance note: This article provides general information for educational purposes and is not legal advice. Always confirm requirements with your medical director and consult your attorney when making operational changes.

Sources & Further Reading



 
 
 

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