Bill Name: House Bill 5087 (H 5087) 

Primary Sponsor: Rep. Alice Peisch

Status: 2/09/2026 Referred to Joint Committee on Public Health, Senate concurs

AmSpa’s Take: There has been a growing national trend to regulate and license medical spas and aesthetic practices. This year alone several states have introduced similar legislation. This type of legislation often creates a burden for compliant practices and does little to address unlicensed actors.

Analysis: Currently, in Massachusetts, as in most states, medical spas are regulated the same as other medical practices. Most medical spas would need to obtain a clinic license unless they are wholly owned by practitioners. If passed, H 5087 would require more complex licensing and practice requirements for medical spas.

Under H 5087, a medical spa is defined to mean a business that provides medical aesthetic procedures. Medical spas that are wholly owned by practitioners are exempt if at least one owner practices on site for a majority of the time at each medical spa location. Practitioners in this bill include physicians, physician assistants (PA), nurses, electrologists and advanced aestheticians. 

The required licensing for medical spas is broken into three different levels based on the types of procedures and treatments offered. Level I procedures include electrology and cosmetology services. Businesses offering level I procedures need to have a license issued by the electrologist or cosmetology boards. Level II and III procedures are considered medical procedures and would require licensing as a medical spa. Level III procedures are more invasive or carry a greater risk than level II. Medical spas can obtain a level II only, level III only, or combined level II and III license. Currently what procedures qualify as level II or III are not stated in the bill and instead are to be determined by the Commissioner of Public Health.

If H 5087 passes, current operating medical spas will have 120 days from the effective date to register and then have one year to submit their application. Medical spas must maintain patient records for at least seven years. All practitioners must have sufficient training in the procedures they provide and be supervised as required by their license. 
This license does not expand any practitioner’s licensed scope of practice. But in order to perform any cosmetic medical procedures, a business must hold a medical spa license, or be a hospital or exempt practitioner owned office. Medical aesthetic procedures are restricted to being provided in these locations, so home or concierge services would no longer be permitted.

Level II medical spas must have a clinical director and a site director. These roles can be held by either physicians or nurses. A clinical director must be physically present at the medical spa at least 10% of the time it is open. The clinical director or an experienced nurse or physician must perform all patient assessments and make referrals as needed. The site director or a designated substitute must be physically present while the medical spa is open. Site directors must be trained in all of the procedures offered at the site and are responsible for the credentialing of all licensed professionals These roles may be held by the same person. 

Level III medical spas must have a medical director who is a physician instead of a clinical director, as well as a site director. Medical directors must have training to supervise and perform all level III procedures offered and must be physically present at least 10% of the time the medical spa is operating. The level III site director has the same responsibilities as the level II site director.  

Unlicensed medical spas are subject to fines and possible imprisonment for subsequent violations. Licensed medical spas are subject to inspection and can be fined for failing to follow regulations. H 5087 also creates a multi-disciplinary advisory committee to review and comment on all proposed rules.

This bill is somewhat unusual in that it requires many things that are already required in Massachusetts while adding much greater complexity and difficulty in compliance. If you would like additional information, to read the language of this bill or to contact the sponsors or committee, you can find the information you need through here: H 5087.