NP / RN / PA Aesthetic Practice FAQ
How much does a medical director cost for a medspa?
Contracted medical director fees for NP-owned medspas typically range from $1,500 to $5,000+ per month in reduced and restricted practice states. The fee depends on state requirements, your practice volume, the physician's specialty, and the level of involvement (chart review frequency, on-site presence, prescriptive oversight).
Medical director compensation is one of the more variable line items in a medspa pro forma. Bands by structure:
Contracted medical director (1099, no equity): - Reduced Practice states (Illinois, Pennsylvania, Ohio, etc.): $1,500–$3,500/month typical - Restricted Practice states (California, Florida, Texas, etc.): $2,500–$5,000+/month typical - Specialty premium: dermatologists and plastic surgeons command higher fees than family medicine or internal medicine physicians
Equity medical director (MSO/PC structure): - Owns the PC, shares in profit - Often a smaller fixed retainer ($1,000–$2,500/month) plus a percentage of net revenue or distributions from the PC - Sometimes structured as a full partnership
What you're paying for: - Standing orders or per-patient prescriptive authority - Protocol review and sign-off - Chart review on a defined schedule (commonly quarterly or monthly samplings) - Availability for emergency consultation (typical 24/7 phone availability for adverse events) - Adverse event response and management - Continuing education and protocol updates as drugs and procedures evolve - Their name on your wall and on your patient consent forms
What you should not be paying for: - A signature on a piece of paper. If your medical director isn't engaged in protocol review and isn't available when something goes wrong, you have a compliance risk, not a working medical director.
State-specific notes:
California requires the medical director to be a California-licensed physician (MD or DO). The medical corporation (PC) ownership requirement means many CA medical directors are equity owners rather than contracted-only.
Florida requires the medical director to be a Florida-licensed MD or DO (not NP) for aesthetic context.
Texas — under the Prescriptive Authority Agreement (PAA) framework, the delegating physician must be Texas-licensed.
New York — post 3,600-hour NPs can directly own a PC, reducing or eliminating the medical-director-as-PC-owner structure.
How to find a medical director:
Direct outreach to physicians in adjacent specialties (family medicine, internal medicine, dermatology, plastic surgery) who already have full-time practices.
Physician-only networks and marketplaces (some specifically serve aesthetic practices — Aesthetic Medical Group, others).
Referrals from established aesthetic practices in your area — colleagues will often connect you with their medical director's network.
State medical society or board referrals — less productive but occasionally surfaces matches.
A red flag check: if a physician is offering to be medical director for an aesthetic practice for $300/month or "in exchange for a percentage of revenue with no real involvement," walk away. That arrangement creates compliance risk for both parties.