Independent Contractors in Texas Med Spas: Legal Considerations and Compliance

As the aesthetics industry continues to expand in Texas, many med spa owners consider hiring licensed professionals—such as injectors, estheticians, or laser technicians—as independent contractors rather than employees. This model can offer financial flexibility, but it comes with significant legal risks if not implemented correctly. Texas law and federal guidelines impose strict requirements for classifying workers as independent contractors, especially in healthcare-related businesses like med spas.

Understanding the Classification: Independent Contractor vs. Employee

In Texas, worker classification is primarily governed by the Texas Workforce Commission (TWC) and the Internal Revenue Service (IRS). The key issue is whether the business has the right to control how the worker performs their job.

Factors that indicate employee status:

• The med spa sets work hours.

• The worker must follow detailed protocols or company procedures.

• The worker uses the med spa’s equipment and supplies.

• The worker cannot delegate tasks or hire their own staff.

• The med spa provides training or supervision.

Factors that support independent contractor status:

• The worker has their own business entity (e.g., PLLC).

• They carry their own malpractice insurance.

• They set their own hours and pricing.

• They operate independently and use their own equipment or space.

• They provide services to multiple med spas or clients.

Texas uses the "direction and control" test, which overlaps heavily with the IRS’s 20-factor test for determining employment status.

Medical Services and Supervision Requirements

Medical services in Texas—such as Botox injections, laser hair removal, or other aesthetic procedures—must be delegated by a licensed physician. Even if the injector is classified as an independent contractor, they must still:

• Work under appropriate physician delegation and supervision.

• Follow a signed standing delegation order or protocol.

• Comply with all Texas Medical Board (TMB) regulations, regardless of employment status.

Misclassifying a healthcare worker to avoid employer obligations (like withholding taxes or providing benefits) can result in penalties from the IRS, the TWC, and professional licensing boards.

Risks of Misclassification

Improperly classifying an employee as an independent contractor can lead to:

• Back taxes, interest, and penalties from the IRS.

• Unemployment insurance claims and fines from the TWC.

• Wage and hour claims under the Fair Labor Standards Act (FLSA).

• Malpractice liability if an unsupervised or inappropriately supervised provider causes harm.

• Disciplinary action from the Texas Medical Board or other licensing authorities.

Best Practices for Med Spas

To legally engage independent contractors in a Texas med spa:

• Use a written agreement that clearly defines the contractor relationship.

• Ensure the contractor is licensed and insured independently.

• Avoid setting fixed hours, quotas, or detailed performance rules.

• Do not provide employee-style benefits, uniforms, or training.

• Allow them to perform services for other clients or businesses.

• Have the contractor use their own tools or supplies where feasible.

Additionally, make sure your medical director and supervising physician understand that delegation and oversight responsibilities apply regardless of the provider’s tax classification.

Conclusion on Independent Contractors in Texas Med Spas

While hiring independent contractors can work in Texas med spas, it must be approached with caution and legal precision. The fact that a provider is a licensed professional does not automatically make them a valid independent contractor. Employers must consider both tax classification laws and healthcare regulatory requirements. Consulting with a healthcare attorney is highly recommended to ensure contracts, protocols, and day-to-day operations are compliant.

Feel free to reach out if you need more specific information or further clarification.

Weitz Morgan is a leading law firm in Texas in providing comprehensive advice and guidance to med spas. With a deep understanding of the unique challenges and complexities faced by this rapidly growing industry, our team of experienced attorneys is dedicated to helping med spas navigate the legal landscape successfully.

We recognize that med spas operate at the intersection of healthcare and beauty, which necessitates a multifaceted approach to representation. Our firm offers a range of services, including a flat-fee med spa formation package and an outside general counsel subscription, tailored to meet the specific needs of med spas, ensuring compliance, mitigating risks, protecting licenses, and fostering a legally sound business environment.