Under Iowa Board of Medicine rules, medical aesthetic services at a medical spa, including Botox and other injectables, may be performed by non-physicians only when delegated by a medical director. The medical director must provide direct, in-person, on-site supervision at least four hours a week, review services on site weekly with at least 10% of charts reviewed, stay within 60 miles at all times, and be reachable in person or electronically at all times. The rule does not apply to physicians directing licensed medical facilities, clinics or practices that offer aesthetic services as part of their other medical services.
Law or regulationPublished or effective May 21, 2025Checked Sep 14, 2026