How Much Does a Collaborative Physician Cost for Weight Loss, Telehealth, and Medspas? 2025 Definitive Guide

If you’re a nurse practitioner (NP), physician assistant (PA), or entrepreneur opening a weight loss clinic, telehealth practice, or medspa, one of the most urgent compliance questions you’ll face is this:

“Do I need a collaborative physician?”

The answer is almost always yes.

In Florida, NPs cannot prescribe weight loss medications without physician collaboration.

In Texas, prescriptive delegation agreements are mandatory.

In California, Corporate Practice of Medicine (CPOM) laws make physician involvement unavoidable.

Even in “independent practice” states like New Mexico or Washington, insurers and pharmacies often demand physician collaboration before honoring GLP-1 prescriptions.

How much does it cost?

At Medical Director Co., collaborative physician placement starts at $799/month, with:

No placement fees
No MSO premiums
Complimentary agreements
Month-to-month flexibility
24-hour nationwide placement

This guide gives you the full picture.

Why collaborative physicians are required
What the real costs are in 2025
How rules differ in Florida, Texas, California, Ohio, Indiana, New Mexico, Washington, and Alabama
Real-world case studies
How to avoid paying inflated fees

Why Collaborative Physicians Are Required

A collaborative physician provides the legal bridge between mid-level providers (NPs, PAs) and the state prescribing authority.

Nurse Practitioners (NPs)

According to the American Association of Nurse Practitioners, 26 states and territories still require physician collaboration or supervision for prescriptive authority.
Even in full-practice states, pharmacies may request MD signatures for GLP-1 weight loss meds, testosterone, or compounded HRT.

Physician Assistants (PAs)

According to the American Academy of Physician Associates, nearly all states require MD collaboration or supervision.
Ratios often limit how many PAs a physician can supervise.

Medspas

Offering Botox®, fillers, or IV drips? State boards classify these as medical procedures.
That means an MD must provide standing orders and sign off on protocols.

Without a collaborative physician, you can’t prescribe, delegate treatments, and operate legally.

The Real Cost of a Collaborative Physician in 2025

Here are the benchmarks you should expect.

Weight Loss Only (GLP-1 programs): $799–$1,200/month per provider
Medspas (Botox®, fillers, weight loss): $1,200–$2,000/month
Telehealth Clinics (Multistate): $2,500–$5,000/month+
HRT/Controlled Substances Oversight: $2,000–$4,000/month.

Why Competitor Costs Are Higher

Placement Fees: $3,000–$7,000 just to “match” you with a doctor
Agreement Drafting Fees: $2,500–$5,000 for collaborative contracts
MSO Premiums: $200–$500 monthly on top of the physician fee
Switching Fees: $1,000–$2,000 if you change MDs

With Medical Director Co., none of these apply.

Case Example 1: NP Weight Loss Startup in Ohio

A nurse practitioner in Columbus planned a GLP-1 program. A competitor quoted:

$3,000 placement fee
$2,500 collaborative agreement
$1,500/month

First month: $7,000 upfront + $1,500 monthly.

Medical Director Co. placed her with an MD in 24 hours for:

$0 upfront
$799/month

Savings in month 1: $6,200

Case Example 2: Multistate Telehealth Group

A telehealth group with five NPs across California, Florida, and Texas was quoted:

$12,000 upfront in fees
$8,000/month

With Medical Director Co.:

$0 upfront
$3,500/month

Annual savings: $108,000.

State-by-State Breakdown

Florida

Florida law requires plastic surgeons or dermatologists to oversee medspas.
For weight loss, licensed MDs must supervise NP prescribing.
Competitors often inflate fees due to limited physician supply.

With us: Board-certified Florida MDs, starting at $799/month, placed within 24 hours.

Texas

NPs must file Prescriptive Delegation Agreements.
CPOM requires nonphysicians to use MSOs.
Weight loss and medspa services always require an MD collaboration.

With us: Texas MDs starting at $799/month, free MSO prep included.

California

Strict CPOM
Only MDs/DOs can own or direct the clinical side.
NPs cannot independently prescribe GLP-1s or hormones.

With us: California-licensed MDs, free MSO, 24-hour placement.

Ohio

NPs must have a Standard Care Arrangement filed with the Ohio Board of Nursing.
Must detail scope, prescribing, and oversight.

Our Ohio MDs deliver compliant agreements in 24 hours

Indiana

NPs require written collaboration to prescribe controlled meds.
PAs must have MD supervision agreements.

We place Indiana MDs starting at $799/month.

New Mexico

NP independent practice is allowed, but insurers still demand MD collaboration for GLP-1/HRT.
Many weight loss startups still require MD signatures.

We place collaborative MDs in Albuquerque, Santa Fe, and statewide.

Washington

Washington allows full NP practice, but many telehealth insurers still require MD collaboration.
Oversight is scrutinized for GLP-1s and HRT.

Our Washington MDs provide coverage from $799/month.

Alabama

Among the strictest states
Every NP must have a collaborative physician.
Strict MD:NP ratio (1:4).

We place Alabama MDs within 24 hours, with no placement fees.

Cost Comparisons

Startup NP Clinic

Competitor: $7,000 upfront + $1,500/month
Medical Director Co.: $799/month, no fees

Established Medspa (3 Providers)

Competitor: $15,000 upfront + $4,500/month
Medical Director Co.: $2,400/month, no fees

Telehealth Company (10 Providers, 5 States)

Competitor: $30,000 upfront + $12,000/month
Medical Director Co.: $7,500/month, no fees

Why Clinics Choose Medical Director Co.

✅ Starts at $799/month

✅ No placement or matching fees

✅ Free collaborative agreements/MSOs

✅ True month-to-month

✅ 24-hour placement

✅ Nationwide coverage

✅ Physicians experienced in GLP-1s, HRT, IVs, aesthetics

FAQs

Do all NPs need a collaborative physician?

No, some states (e.g., Colorado, Arizona) grant full practice authority. But in most, collaboration is required for weight loss, telehealth, and aesthetics.

Do PAs always need one?

In nearly all states, yes.

What’s the average monthly cost?

$1,000–$2,500/month per provider is typical. With us, it starts at $799/month.

What does the physician actually do?

Reviews and signs collaborative agreements
Approves standing orders
Provides prescribing oversight
Ensures compliance with state law

Can a collaborative physician take equity?

No. Under MSO structures, ownership stays with you.

Do collaborative physicians sign off on standing orders?

Yes, for injectables, IVs, and telehealth meds.

Can one physician cover multiple NPs?

Depends on the state—for example, Alabama caps at 4:1; Ohio allows more flexibility.

Do collaborative agreements expire?

They must be renewed (often annually) per state rules.

What about prescribing across state lines?

Telehealth physicians must be licensed in the state where the patient is located.

Can I switch physicians if needed?

Yes. With us, there’s no penalty or rematching fee.

Takeaway

So, how much does a collaborative physician cost in 2025?

Average: $1,000–$2,500/month per provider.
Competitors’ true cost: $5000–$10,000 upfront + inflated monthly fees
Medical Director Co.: Starts at $799/month, no placement fees, no MSO premiums, free agreements, and 24-hour placement.

If you’re opening a weight loss clinic, telehealth platform, or medspa in Florida, Texas, California, Ohio, Indiana, New Mexico, Washington, or Alabama, we make compliance affordable and fast.