Medical spas in Indiana

Indiana has no statute or rule that names Botox or fillers. The medical spa act lists botulinum toxin injections and dermal fillers among the cosmetic treatments that can make a business a medical spa.¹ It does not say who may give them. The responsible practitioner must make sure each person working at the spa is licensed to do the treatments they perform, that the treatments are within that person's scope of practice, and that the person has had appropriate training.¹

The practice of medicine includes giving any form of treatment and surgery that penetrates the skin.³ The practice act excludes nurses under their own act, physician assistants, and "an employee of a physician or group of physicians" doing acts customarily within the employing physician's practice under the physician's direction and supervision. That employee may not make a diagnosis or prescribe a treatment, and may not give medication without the employing physician's specific order.³ A physician assistant works in a dependent practice with a collaborating physician and may do the duties the physician delegates, including prescribing, under a written agreement that lists the tasks and is submitted to the Board.⁴ Prescriptive authority for an advanced practice registered nurse is a Board of Nursing programme, and registered nursing includes carrying out regimens a physician delegates.⁵ We found no Indiana Board of Nursing position on cosmetic injections.

Ask who will inject you, what their licence is, and who the spa's responsible practitioner is.

Indiana has no licence for people who run lasers or energy devices, and we found no statute or rule that requires a physician for cosmetic laser or intense pulsed light treatment. The practice of medicine includes surgery in which tissue is "cut, burned, or vaporized" by a laser.³ Cosmetic non-ablative lasers and intense pulsed light are not mentioned, and we found no Medical Licensing Board or Board of Nursing statement on them. No training hours are stated anywhere in the texts we read.

The cosmetology law defines an esthetician as a person who engages solely in listed skin care, makeup and hair removal by depilatories, waxing or tweezers. Lasers are not on the list, and the law does not bar them either.⁸ An Indiana appeals court held in 2008 that cosmetic laser hair removal by a registered nurse in a physician's office was not "health care" under the state's Medical Malpractice Act. That was a question about the malpractice act, not about who may be licensed.¹² The medical spa act counts a non-surgical laser as a marker of a medical spa, but only if the business also uses prescription drugs by injection or IV.¹ If you are booked for a laser or light treatment, ask who will run the device, which licensed professional is responsible, and whether that person will be on site.

We found no Indiana text on chemical peels or microneedling. The esthetician definition covers facials, makeup, skin care, and beautifying, massaging or cleaning the body with cosmetic preparations, antiseptics, tonics, lotions or creams.⁸ Ask who will do the treatment, what their licence is, and whether a physician or nurse oversees it.

We found no Indiana statement on IV hydration. The medical spa act lists parenteral nutrient therapies among its examples and covers a business that uses prescription drugs for intravenous delivery, so a drip business that dispenses prescription drugs is in its scope once registration starts.¹ Registered nursing includes carrying out regimens a physician delegates.⁵ We found no IV-specific nursing rule. A registered spa may not treat clients away from the spa office, except for training, which would bar a mobile service from 2027.¹ Ask who ordered the drip, who evaluated you, and who will place the IV.

Weight loss is one of the treatments that can make a business a medical spa under the act.¹ The same act adds rules on compounding, in effect since 1 July 2026. Compounded drugs must be made from a bulk drug substance that is not research grade or veterinary grade, was made by an FDA-registered human drug establishment, and comes with a certificate of analysis and quality testing, and the work must meet federal law and the United States Pharmacopeia. Compounding covers a pharmacist, a physician, or a person under their supervision. The Board of Pharmacy has primary authority to investigate sourcing, storage, labelling, handling and compounding of prescription drugs, and the state must publish a report twice a year on compounding oversight that includes the number of medical spas that compound.¹ We found no Indiana board statement on semaglutide or tirzepatide. Ask whether your medicine is FDA-approved or compounded, and which pharmacy prepares it.

Registration. A medical spa is a facility or practice that offers medical health care services, uses prescription drugs for IV, intramuscular or subcutaneous delivery, and holds itself out as focused on cosmetic or lifestyle treatments. The law does not apply to a physician's office or to a facility or practice otherwise licensed by the state.¹ The Board has not said what counts as a physician's office, according to a trade body's report.¹¹ The Board was to set a registration procedure by 1 October 2026. The application asks for the spa's names, address, website, services, whether it compounds, and the name and licence number of its responsible practitioner. The Board must keep a public database of this information. It may fine a person who runs an unregistered spa up to $5,000.¹ The American Med Spa Association reports that the Board announced on 30 September 2026 that registration opens on 1 January 2027.¹¹ The Board's May and June 2026 agendas list the registration under the director's report.⁹

Responsible practitioner. The practitioner must be a physician, an advanced practice registered nurse with prescriptive authority under the nursing programme, or a physician assistant with delegated prescriptive authority. They must have education and training in the services and medications at the spa. They must be physically present at the spa for "a sufficient amount of time" to make sure the spa follows the law. The act does not say how long that is.¹ Indiana law has no "medical director" office; the responsible practitioner is the closest role. A spa must tell the Board of a serious adverse event within 15 days, and its advertising must follow the health care advertising law.¹ That law requires an advertisement naming a practitioner to state the profession or licence they hold.⁷

Ownership. The act sets no ownership rule. The practice act says a physician's employment by a hospital or a health care organisation owned by licensed providers is not the unlawful practice of medicine, as long as the entity does not direct or control the physician's independent medical acts, decisions or judgment.³ We found no express ban on lay ownership of a medical practice. The Medical Licensing Board's rules bar splitting a fee with a practitioner who is not a partner, employee or shareholder, unless the patient consents after disclosure and the split matches services performed.⁶ Whether a particular spa is organised lawfully is a question for a health-care lawyer.