Yes. Good Faith Exam laws differ significantly from state to state, and for Med Spa operators, these differences shape everything from staffing to scheduling. Some states require Good Faith Exams to be done via live video so the provider can interact with the patient in real time, while others allow advanced practice providers to perform them independently. A few have carved out special rules for certain treatments like IV therapy or weight loss programs.
This makes state-specific knowledge essential. A process that is compliant in one state could create compliance risk in another.
Last updated: September 18, 2025
Where States Differ
States vary most in four key areas:
- Who can perform the exam (physician, nurse practitioner, or physician assistant, with supervision rules that change by state).
- Telehealth permissions (some states allow virtual exams freely, others impose conditions).
- Synchronous versus asynchronous requirements (most require live video, but a few are expanding to allow store-and-forward).
- Treatment-specific carve-outs (some states add special rules for IV therapy, weight loss, or energy-based devices).
If you need a refresher on the basics, see What is a Good Faith Exam. If you’re considering efficiency, read How long does a Good Faith Exam take and What is the average wait time to connect with a Spakinect provider.
State Snapshot Table
This table reflects the landscape as of September 18, 2025. Rules may evolve, so always verify current requirements before making operational decisions.
| State | Telehealth Good Faith Exam Allowed | Sync or Async | Who Can Perform | Recent Notes |
| Texas | Yes, with conditions | Primarily synchronous (live video) | MD, NP, PA (with supervision rules) | New law clarified supervision and staffing for elective IV therapy, effective Sept 1, 2025 |
| California | Yes | Synchronous required for most cases | MD, NP, PA | “Appropriate prior examination” standard applies to aesthetic services |
| Florida | Yes | Synchronous audio-video is the norm | MD, NP, PA | Registration required for out-of-state telehealth providers |
| Arizona | Yes | Synchronous for most aesthetic services | MD, NP, PA | Annual Good Faith Exam expectation emphasized in board guidance |
| Washington | Yes | Both synchronous and asynchronous now allowed in defined contexts | MD, NP, PA | 2025 legislation broadened definition of telehealth encounters |
| New York | Yes | Synchronous required | MD, NP, PA | Active enforcement focus on Med Spa operations and supervision rules |
What This Means for Med Spas
If you operate in one state, your compliance strategy is relatively straightforward: align your workflow to your local medical and nursing boards. If you operate across multiple states, the complexity grows. What is allowed in Arizona may not be allowed in New York.
To protect your practice:
- Only use properly licensed providers (physicians, nurse practitioners, or physician assistants). (See also: Who can perform a Good Faith Exam)
- Document every exam thoroughly in your EMR and client portal.
- Watch for new regulations around high-risk services like IV therapy or weight loss treatments.
- Assume synchronous video is required unless your state clearly allows asynchronous methods.
Spakinect’s Advantage
Spakinect currently provides Good Faith Exams in 38 states and counting. That coverage helps single-location Med Spas stay compliant with local rules while also giving multi-location practices one consistent partner across multiple jurisdictions.
Every exam is performed by licensed providers trained in state-specific laws. Patients connect in 1 to 2 minutes, exams are completed in 4 to 15 minutes, and all documentation is stored securely in the client portal and integrated with your EMR.
You can view our full coverage map here: States We Service.
FAQ: Good Faith Exam Laws by State
Are Good Faith Exam laws the same nationwide?
No. Each state defines its own rules for who can perform exams, whether telehealth is permitted, and how exams must be conducted.
Can all states use virtual Good Faith Exams?
Most allow them, but with conditions. Some require live audio-video encounters, while a few are beginning to allow asynchronous telehealth in defined situations.
Who can legally perform the exam?
Only physicians, nurse practitioners, and physician assistants. Registered nurses, medical assistants, and estheticians are not authorized. (See also: Who can perform a Good Faith Exam.)
What happens if a Med Spa ignores state-specific rules?
Regulators may issue fines, launch investigations, or suspend licenses. It also increases malpractice liability if a patient is harmed.
How does Spakinect handle state differences?
Our provider network is trained in state-by-state requirements. Every exam follows the rules in the patient’s state, ensuring your practice stays compliant without slowing down workflow.
