Month-to-Month Medical Director Contracts for Medspas: The Truth About Fees, Flexibility, and Compliance

If you’re opening or scaling a medspa, one of the first compliance hurdles is finding a medical director. 

Whether you’re in California, Florida, Texas, Arizona, North Carolina, or Georgia, every medspa is classified as a medical practice under state law. That means you must operate under the oversight of a licensed physician.

But here’s where things get tricky.

Most companies offering medical director services promote “month-to-month contracts.” On the surface, it sounds like flexibility. In reality? They load you with thousands of dollars in upfront fees—placement charges, matching fees, and MSO premiums—which lock you in long-term, even if the relationship isn’t working.

At Medical Director Co., we’ve re-engineered this process.

• Pricing starts at $799/month
• No placement fees
• No MSO premiums
• Complimentary MSO agreements
• No switching fees
• 24-hour nationwide placement

This guide breaks down:

• Why true month-to-month contracts matter.
• The traps competitors use to keep you stuck.
• What medical directors actually cost in different states.
• Why California and Florida are stricter than most.
• How our model keeps you compliant, flexible, and in control.

Why Every Medspa Needs a Medical Director

Every medspa delivers medical procedures: Botox®, fillers, IV drips, PRP, weight loss injections, and laser treatments. By law, these services require physician oversight.

A medical director provides:

• Prescriptive authority for Botox®, fillers, antibiotics, weight loss meds, nausea treatments, etc.
• Standing orders & treatment protocols that your RNs or NPs work under.
• Supervision for nonphysician staff (RNs, PAs, NPs).
• Compliance with your state board of medicine.
• Liability coverage to protect your business.

Without one, you risk fines, shutdowns, malpractice exposure, and loss of insurance coverage.

So yes, you need a medical director. The real question is: at what cost, and under what terms?

The Problem with “Month-to-Month” in the Industry

Most competitors know medspa owners want flexibility. That’s why they advertise “month-to-month contracts.” But look closer, and you’ll see the traps.

1. Placement Fees

Before you can even work with a medical director, many companies tack on a steep “placement” cost.

Expect $3,000–$7,000 upfront—oh, and you won’t get it back, even if you cancel after one month.

2. MSO Premiums

Most medspas require an MSO (Management Services Organization) agreement to stay compliant.

Competitors charge $2,500–$5,000 upfront, plus $200–$500 monthly MSO “maintenance fees.”

3. Switching Fees

Need to change MDs? That’ll be another $1,000–$2,500.

4. Psychological Lock-In

After sinking $7,000–$10,000 upfront, you feel forced to stay even if the MD is unresponsive.

The result? It’s not really month-to-month. It’s a long-term commitment disguised as flexibility.

Why True Month-to-Month Matters

Medspas are dynamic businesses:

• You may start with a single injector, and then expand rapidly.
• You may add new services—IV therapy, weight loss, or advanced lasers.
• You may open multiple locations.
• You may even pause operations or pivot your model.

A true month-to-month medical director contract ensures:

• Flexibility: Adjust oversight as your business evolves.
• Control: No sunk costs tying you down.
• Scalability: Add or remove providers without renegotiation headaches.
• Confidence: If your MD isn’t the right fit, you can switch without penalty.

Traditional Firms vs. Medical Director Co.

Feature	Traditional Firms	Medical Director Co.
Placement Fee	$3,000–$7,000 upfront	$0
MSO Agreement	$2,500–$5,000 + $200–$500 monthly	Included = Free
Switching Fee	$1,000–$2,500	$0
Contract Term	“Month-to-month,” but sunk costs keep you stuck	True month-to-month
Pricing	$1,200–$2,000+/month	Starts at $799/month

State-by-State Realities

California

• Strict Corporate Practice of Medicine (CPOM)
• Only licensed physicians (MD/DO) can be medical directors.
• RNs and NPs cannot own or direct medical care.
• MSO structures are required for nonphysician owners.
  • Competitors exploit this by charging high MSO premiums.
  • Our MSOs are complimentary for California medspas.

Florida

• Only plastic surgeons or dermatologists can be medical directors.
• General physicians (family medicine, pediatrics, psychiatry) don’t qualify.
• The scarcity of specialists makes competitors charge higher placement fees.
  • We place board-certified plastic surgeons in Florida within 24 hours—no placement fees, no MSO premiums.

Texas

• CPOM applies—RNs and nonphysicians must use MSOs.
• Oversight fees can rise due to strict delegation rules.
  • We provide Texas medical directors starting at $799/month, with free MSO agreements.

Arizona

• More flexible than most states
• NPs may sometimes own medspas outright, but RNs and nonphysicians still need MD oversight.
  • We provide month-to-month coverage with no premiums.

North Carolina

• CPOM rules prohibit RNs, NPs, and entrepreneurs from owning the clinical side.
• Only physicians may serve as medical directors.
• MSO agreements are mandatory.
  • With us, your MSO agreement is complimentary.

Georgia

• Very strict CPOM enforcement
• Only physicians can own or direct medspas.
• RNs and NPs must partner via MSO agreements.
  • We place Georgia medical directors within 24 hours, starting at $799/month.

Real-World Scenarios

Startup Medspa (One Provider)

• Traditional Firm: $5,000 placement + $3,000 MSO + $1,200/month = $9,200 startup cost
• Medical Director Co.: $0 upfront + $799/month = $799 startup cost

Savings in Month 1: $8,400

Multilocation Medspa (3 Providers, 2 Cities)

• Traditional Firm: $10,000 upfront + $5,500/month
• Medical Director Co.: $0 upfront + $2,400/month

Savings in Year 1: $80,000+

FAQs

How much does a medical director cost per provider?

Industry average is $1,000–$1,250/month. With us, it starts at $799/month.

Do you charge placement or MSO prep fees?

No, both are included free.

Can I cancel anytime?

Yes, ours are true month-to-month contracts.

What if I expand my staff?

Your fee adjusts per provider—no renegotiation costs.

Do medical directors take equity in my business?

No, the MSO structure ensures you keep 100% ownership.

How fast can I get placed?

We place medical directors in as little as 24 hours nationwide.

Takeaway

Here’s the truth about month-to-month medical director contracts for medspas:

Most companies use them as a marketing hook and then trap you with huge upfront costs— placement fees, MSO premiums, switching fees. 

Once you’ve spent the money, you’re stuck.

At Medical Director Co., we’ve eliminated those traps.

• Pricing starts at $799/month.
• No placement fees
• No MSO premiums
• Complimentary MSO agreements
• No switching fees
• 24-hour nationwide placement

Ready for a medical director partnership that’s truly flexible? Contact us now and launch your medspa the right way—compliant, affordable, and month-to-month.