AmSpa's New Practice Guidelines Support RNs Working Without Onsite Supervision

Posted By Mike Meyer, Friday, September 25, 2020

microneedling treatment

The American Med Spa Association (AmSpa) seeks to clarify its recommendations for RNs and physician oversight found in its newly released Guidelines for Non-Surgical Medical Practice (Medical Spas).

It has become clear from AmSpa's valued members and the industry at large that there is a misconception about what the wording in the practice guidelines indicates in regard to RNs working without onsite supervision in medical spas. The following is to clarify what the practice guidelines are recommending with regard to RNs and supervision. The Guidelines for Non-Surgical Medical Practices (Medical Spas)recommend the following (depending on your state's regulations):

  1. RNs CAN operate non-ablative lasers, light treatments and energy device treatments without direct onsite supervision.
  2. RNs CAN perform microneedling treatments without direct onsite supervision.
  3. RNs CAN perform the injection of fillers, neuromodulators and PDO threads without direct onsite supervision.

However, a face-to-face examination, including appropriate history and physical, must be performed by a physician—or nurse practitioner (NP) or physician assistant (PA), under appropriate circumstances—who is trained, qualified and experienced in the desired medical procedure prior to performing the initial medical procedure.

The statement that RNs, PAs and NPs require direct supervision to perform ablative laser treatments is currently under consideration, based on the fact that the definition of "ablative laser treatments" isn't clear. AmSpa will be putting out a final decision on this in the following weeks.

In the verbiage of Guidelines for Non-Surgical Medical Practice (Medical Spas), the term "general supervision" is used. Legally, treatments offered under "general supervision" are services being furnished under the physician's overall direction and control, but the physician's presence is not required during the performance of the procedure.

AmSpa will be hosting a virtual roundtable next week with leading RNs in the industry to discuss what the AmSpa Practice Guidelines mean for RNs. Stay tuned for more information on how to sign up to attend this free roundtable to get clarification on what AmSpa's Practice Guidelines are recommending for RNs. Comments on these Practice Guidelines can be directed to

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