RIDOH Proposes Amendment to Physician Licensure Rules Defining Cosmetic Injectables as Nonsurgical

On March 2, 2026, the Rhode Island Department of Health filed a proposed amendment to physician licensure regulation 216-RICR-40-05-1, clarifying that certain cosmetic injections, including Botox, hyaluronic acid fillers, PRP, and PRF, are not considered surgery. If adopted, the adjustment would be relevant to Med Spa providers offering injectable cosmetic treatments.

Rhode Island Physician Licensure Rule: Proposed Change for Injectables

The Rhode Island Department of Health (RIDOH) has proposed amending physician licensure regulation 216-RICR-40-05-1 to clarify that injections of onabotulinumtoxinA (Botox), hyaluronic acid fillers, platelet-rich plasma (PRP), and platelet-rich fibrin (PRF) for cosmetic purposes are excluded from the regulatory definition of surgery. The proposal was filed with the Rhode Island Department of State on March 2, 2026, and is open for public comment through April 1, 2026. As of this reporting, existing regulations remain in effect, but if adopted, the amendment would clarify how certain injectable cosmetic treatments commonly offered in Med Spa settings are categorized under Rhode Island physician licensure rules.

RIDOH Proposal: Cosmetic Injectables Are Not Surgery

The amendment proposed on March 2, 2026, would specify that injections of certain medications and autologous plasma products for cosmetic purposes are not included in the regulatory definition of surgery. The filing shows several injectable aesthetic treatments commonly performed in clinical and Med Spa settings, including:

• • OnabotulinumtoxinA (Botox)
  • Hyaluronic acid dermal fillers
  • Platelet-Rich Plasma (PRP)
  • Platelet-Rich Fibrin (PRF)

The amendment is intended to clarify how these procedures are categorized under physician licensure regulations. The RIDOH published guidance in November 2023 stating that services offered by Med Spas and IV therapy businesses involving prescription medications are considered medical procedures and must be performed by appropriately licensed providers under physician oversight, wherever required.

If adopted, the amendment would clarify that certain injectable cosmetic procedures commonly performed in Med Spas and physician-supervised clinics are not considered surgery. These injectables would be considered medical procedures, without changing existing scope-of-practice or physician supervision requirements. As of this news report, current regulations governing Med Spa injectable services in Rhode Island remain unchanged.

Rulemaking Notice and Source Documents

According to the Rhode Island Department of State rulemaking record, the Rhode Island Department of Health filed a proposed amendment to physician licensure regulation 216-RICR-40-05-1 on March 2, 2026. The proposal remains open for public comment until April 1, 2026, and no changes have been adopted as of this reporting.

Context for Cosmetic Injectable Services in Rhode Island Med Spas

The proposed change to 216-RICR-40-05-1 would clarify how certain injectable cosmetic procedures are categorized under Rhode Island physician licensure rules. In the proposed rule text filed under the Rhode Island Administrative Procedures Act, the Rhode Island Department of Health specifies that injections of onabotulinumtoxinA, hyaluronic acid fillers, platelet-rich plasma (PRP), and platelet-rich fibrin (PRF) for cosmetic purposes are excluded from the regulation’s definition of surgery.

For clinics providing aesthetic injections, including Med Spas, physician-supervised aesthetic practices, and wellness clinics offering PRP treatments, the clarification defines how these procedures are categorized under physician licensure rules. By distinguishing that these cosmetic injections are not considered surgery, the amendment separates these treatments from procedures regulated as surgical services under applicable licensure for physicians in Med Spas, physician-supervised practices, and wellness clinics offering PRP or filler treatments.

Recent legislative and enforcement actions in other jurisdictions have focused on regulating cosmetic procedures involving prescription medications in Med Spa settings. In a New York City Council investigation, 15 Med Spas were cited for potential regulatory violations involving medical procedures and oversight. Additionally, in January 2026, Florida lawmakers proposed legislation to address prescription drug oversight in Med Spa settings. Similar legislative and regulatory actions have addressed how cosmetic treatments are classified and supervised.

Operational Considerations for Med Spa Providers Offering Cosmetic Injectables

• Confirm all injectable services are performed by licensed providers operating within the Rhode Island scope-of-practice requirements.
• Maintain documentation of physician oversight consistent with RIDOH guidance for Med Spa and IV therapy businesses.
• Ensure patient consent and treatment documentation clearly identify injectable cosmetic procedures and the supervising physician.
• Establish protocols for preparing PRP or PRF treatments, including properly handling autologous blood products.
• Review clinic services and procedure classifications to ensure injectable cosmetic procedures are described appropriately.

Next Steps in the RIDOH Rulemaking Process

The proposed amendment to 216-RICR-40-05-1 remains in the rulemaking phase following its filing by the Rhode Island Department of Health on March 2, 2026. The proposal is open for public comment through April 1, 2026, after which RIDOH may review feedback and revisions under the state’s Administrative Procedures Act. At this time, there are no official changes to the rule.

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Image Attribution: “Rhode Island State Capitol (north facade)” by Garrett A. Wollman, via Wikimedia Commons, licensed under CC BY-SA 2.5.