Med spa · Colorado

Colorado med spa MSO-PC: who may inject, laser rules, and who owns the practice

Colorado treats Class IIIb lasers, intense pulsed light, and injections as medical-aesthetic services. Corporations shall not practice medicine. See where the physician-owned PC fits.

Updated November 4, 2026

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A Colorado med spa that injects a substance or uses a Class IIIb or higher laser, radio-frequency device, or intense pulsed light is providing a medical-aesthetic service under Rule 1.17 of 3 CCR 713-1 (Colorado Medical Board rules, current version effective February 26, 2026). That rule implements delegation under C.R.S. 12-240-107(3)(l). It does not govern physician assistants or registered nurses, who follow their own rules and the Nurse Practice Act. Ownership sits in C.R.S. 12-240-138: corporations shall not practice medicine, and physician shareholders keep majority ownership. HB26-1249 would have loosened that for medical-aesthetic corporations. The House postponed it indefinitely on March 25, 2026. It is not law. A lay founder owns the MSO. Foundry forms that MSO-PC for $15,000 one-time and matches a Colorado-licensed friendly PC owner for $3,000/mo.

Colorado is Strict on the CPOM 50-state guide. The professional-entity rule and the hospital-employment carve-out in C.R.S. 25-3-103.7 are on Colorado CPOM. For the general aesthetics build, start at the med spa MSO-PC hub. After papers, run CPOM compliance. Adding virtual consults? Read the Colorado telehealth MSO-PC guide. General information only, not legal advice. Foundry is not a law firm.

Who may do what in a Colorado med spa

Service	Who the rule names	Colorado rule
Injection of a substance	A physician, or a person who may receive a delegation that meets Rule 1.17. RNs follow the Nurse Practice Act	3 CCR 713-1, Rule 1.17(D)(2). Off-label use needs a specific physician delegation and must sit inside accepted practice
Class IIIb or higher laser, RF, IPL, or a technique that structurally alters tissue, including hair removal	Practice of medicine. Unlicensed delegates only under Rule 1.17	Rule 1.17(D)(2) and (D)(3). Class I, II, and IIIa devices are not medical services under the rule
Microdermabrasion, permanent makeup, and barber or cosmetology services	The license that statute actually covers	Rule 1.17(D)(4) says these are not medical services. Esthetician scope is C.R.S. 12-105-104
Prescribing	The licensed prescriber. Not an unlicensed delegate	Rule 1.17(D)(6) says prescribing of drugs may not be delegated under C.R.S. 12-240-107(3)(l)

Colorado Medical Board Rule 1.17 is the delegation rule for people who are not licensed to perform the delegated medical service. The delegating physician has to be qualified to perform the service personally and must still perform it as part of practice, not only by delegating. Before the delegate works outside the physician's presence, the physician personally observes the delegate perform the service. A delegate may not use the title medical esthetician when the person is not licensed to perform medical services. Delegated services cannot be passed on to someone else by the delegate.

Supervision is written down. The physician provides ongoing inspection, evaluation, advice, and control, and decides the necessity and method of treatment. On the premises and readily available is the default. Off premises is allowed only with written procedure protocols and written emergency protocols that the physician writes, while the physician stays physically in Colorado and can attend promptly. Quality is monitored at the site at least every two weeks. Charts are reviewed within 14 days, and the physician initials and dates each entry reviewed. Once a year the physician reassesses the delegate, including over-the-shoulder observation. The written agreement (Appendix A of the rule) is available to the public at the site, unless the physician is on site and personally directing the delegate at least 60 percent of the time, in which case job descriptions can document the relationship.

Who owns the Colorado practice

Role	Where it sits	Colorado note
Physician owner	Owns the professional entity	Colorado-licensed MD or DO, majority of the shares. A PA may hold a minority only while physicians keep majority ownership under C.R.S. 12-240-138(1)(d)
Clinical authority	The PC, not a lay LLC	C.R.S. 12-240-138(6)(a): corporations shall not practice medicine. C.R.S. 25-3-103.7 is hospital employment, not a startup waiver
Injectors and laser staff	Employed or contracted by the PC	Rule 1.17 for unlicensed delegates. Nurse Practice Act for RNs. Do not staff the medical menu on the MSO
Founder and investors	Own the MSO	Lease, brand, booking, retail products, marketing. HB26-1249 did not open PC shares to estheticians or lay owners
MSO fee	Written management services agreement	Fixed or cost-plus at fair market value. Run the MSA red-flag audit

Treatment revenue belongs to the PC. Retail product that is not a professional service can sit in the MSO. A Delaware LLC can own the MSO. It is not a substitute for a Colorado-licensed physician on the professional entity. If any patient is in Utah, Utah requires a domestic professional entity. See Utah CPOM. To file the two companies, use MSO-PC formation.

HB26-1249 did not change the owner

HB26-1249 was introduced February 18, 2026. It would have let physician assistants own a majority of a corporation organized only for medical-aesthetic services, and it would have let an esthetician, cosmetologist, practical nurse, registered nurse, advanced practice registered nurse, or physician assistant be a shareholder of that corporation. On March 25, 2026, the House Health and Human Services committee postponed the bill indefinitely, 13 to 0. The final fiscal note, dated August 3, 2026, says the bill was postponed indefinitely and the impacts do not take effect. C.R.S. 12-240-138 is the rule to build on. Do not staff or sell a med spa as if that bill passed.

Setup steps for a Colorado med spa

List every treatment. Mark injections, Class IIIb and higher devices, IPL, and anything that is only cosmetology.
Match a Colorado-licensed physician to own the professional entity through friendly PC owner matching ($3,000/mo). Physician shareholders stay the majority.
Form the Colorado professional entity and the MSO, and sign a fair-market-value MSA. See MSO-PC formation ($15,000). Typical formation is 1 to 3 days after the menu, the states, and the physician match are scoped. Payer enrollment runs on the payer's clock.
Write the Rule 1.17 file: training, over-the-shoulder sign-off, protocols, the public written agreement, and the 14-day chart review. Do not title an unlicensed delegate as a medical esthetician.
Route all treatment payments to the PC and pay the MSO its fixed fee. Then run CPOM compliance.

Pricing

MSO-PC formation

$15,000

One-time. The MSO and the Colorado physician-owned PC, scoped to your service menu.

Friendly PC owner

$3,000/mo

A Colorado-licensed physician who owns your PC.

Colorado med spa MSO-PC FAQ

Who can inject Botox in a Colorado med spa?

Rule 1.17 of 3 CCR 713-1 treats an injection of a substance into the body as a medical-aesthetic service and the practice of medicine, aside from the narrow items the rule excludes. Delegation of that service to a person who is not licensed to perform it has to meet the rule, including a written agreement and physician supervision. An esthetician license under C.R.S. 12-105-104 covers facials, cosmetic preparations, massage, and hair removal by depilatories, wax, or tweezers. It does not add injections. Registered nurses are governed by the Nurse Practice Act, not by Rule 1.17.

Which lasers are the practice of medicine in Colorado?

Rule 1.17 says use of a Class IIIb or higher laser, a radio-frequency device, intense pulsed light, or another technique that revises, destroys, incises, or otherwise structurally alters human tissue, including for hair removal, is a medical-aesthetic service. The same rule says use of Class I, II, and IIIa devices, including those lasers, is not a medical service. Tattooing, permanent makeup, microdermabrasion, and services regulated by the Barber and Cosmetologist Practice Act, C.R.S. 12-105-101, are not medical services under the rule.

Does the Colorado physician have to be in the room?

Except as Rule 1.17 allows, the delegating physician must be on the premises and readily available. If the physician is not on the premises, written procedure protocols and written emergency protocols have to be in place, and the physician must be physically present in Colorado and available to attend the patient promptly. The physician reviews the delegatee's care within 14 days and monitors quality at the site at least every two weeks. The rule does not set a fixed minute count.

Can a lay founder own a Colorado med spa?

Not the medical practice. C.R.S. 12-240-138(6)(a) says corporations shall not practice medicine. Shareholders are physicians licensed by the Colorado Medical Board, and a physician assistant may hold shares only while physician shareholders keep majority ownership. HB26-1249 would have added a medical-aesthetic shareholder exception. The House Health and Human Services committee postponed that bill indefinitely on March 25, 2026. It is not law. A lay founder can own the MSO and pay a fixed fair-market-value fee.

How much does Foundry charge for a Colorado med spa MSO-PC?

MSO-PC formation is $15,000 one-time. A Colorado-licensed friendly PC owner is $3,000/mo.

Ready to open your Colorado med spa?

Book a free 20-minute call with your service menu. We will scope the PC, the MSO, and the physician owner.