IV Infusion Therapy Standard.
Any Medspa Board–certified med spa, aesthetics practice, or wellness clinic offering IV infusion therapy must meet this standard, developed by our advisory board. IV therapy must be offered only as a medical service, under appropriate clinical oversight.
Last reviewed:This sets Medspa Board's minimum safety and documentation standards for IV infusion therapy. It does not replace state law, board rules, or legal counsel — and many of its requirements overlap with the eight core Certification Requirements. Where a stricter state law applies, follow the state law.
Clinical Oversight
IV infusions require the same clinical oversight as every other medical service in the practice.
- A qualified medical director or other legally authorized clinician is responsible for all IV services.
- Every IV infusion is prescribed by a licensed professional with prescriptive authority in their state.
- Every patient receives a good faith exam at intake, performed by a nurse practitioner, PA, or physician — updated annually.
- Written protocols, approved by the medical director, define which therapies may be offered and patient exclusion criteria.
- Before offering any IV therapy, the practice confirms with its malpractice/liability carrier that each specific therapy is a covered service — and keeps documentation of that confirmation. The carrier is notified, and coverage reconfirmed, before adding any new IV therapy type.
Patient Screening & Consent
- Medical history, medications, allergies, contraindications, and baseline vital signs are documented before every treatment.
- A treatment-specific written consent covers expected effects, risks, alternatives, and when to seek emergency care.
- For repeat infusions, baseline or follow-up lab review and/or coordination with the patient's primary-care clinician is required when clinically indicated.
Medications & Supplies
- IV bags, medications, and additives are purchased only from licensed medical suppliers, manufacturers, or appropriately licensed compounding pharmacies.
- Sourcing, storage, lot numbers, expiration dates, and beyond-use dates are documented.
- Compounding-pharmacy instructions are followed, and product is discarded at the required expiration or beyond-use date.
- Any compounded sterile preparation complies with USP <797> and applicable state pharmacy/compounding law.
Administration & Monitoring
- IV therapy is administered only by appropriately licensed personnel, acting within their state-specific scope of practice.
- A patient is never left unattended during an infusion. Monitoring includes documented, time-stamped check-ins by trained staff at intervals defined in the practice's protocol — at minimum every 10–15 minutes.
- When a practice runs multiple infusion chairs at once, staffing is sufficient to allow direct, in-person check-ins at the required interval for every patient. Video monitoring or intercom systems may supplement but never replace in-person checks.
- Each check-in is documented, including patient status and any symptoms reported, using a documented escalation protocol for symptoms or adverse events.
- Infusion rates are never accelerated for convenience — the ordered protocol and product-specific guidance are followed.
- A new sterile needle and syringe is used for every patient and every medication access; single-dose medications, IV solutions, syringes, needles, and administration sets are never reused between patients.
Staff Training
- Staff administering IV therapy are appropriately licensed under state law.
- Staff complete documented training in IV administration, infection prevention, recognizing adverse reactions, and emergency procedures — with competency demonstrated initially and periodically thereafter.
- All staff administering IV therapy hold current BLS certification.
Emergency Preparedness
- On-site and immediately accessible: AED/defibrillator, oxygen, bag-valve-mask and airway equipment, blood-pressure cuff and pulse-oximetry equipment, and epinephrine (an auto-injector or IM epinephrine) along with other medications for foreseeable emergencies, such as diphenhydramine and corticosteroids for anaphylaxis.
- Written response protocols for anaphylaxis, respiratory distress, hypotension/syncope, chest pain, and cardiac arrest — including EMS activation.
- Staff are trained in emergency recognition, response, calling EMS, and documenting adverse events.
- Emergency readiness is reviewed at regular intervals, with drills or training documented.
Documentation & Quality Review
- A complete record is kept for every infusion: assessment, order, product/source, lot and expiration data, dose/rate, monitoring, clinician involved, and outcome.
- Adverse events, near misses, and product or sourcing concerns are documented and reviewed.
- Emergency equipment and medications are routinely inspected, with periodic audits of infection-control and medication-safety practices.
- Corrective action is documented when deficiencies are identified.
- Any IV offering is paused or discontinued when safety, sourcing, staffing, or monitoring requirements can't be met.
Prohibited Services & Claims
Medspa Board will not certify a spa that offers any of the following. These are high-risk infusions that do not belong in an outpatient medical spa or wellness clinic setting:
- NAD+ IV infusions, including compounded NAD+
- IV iron
- Biologic or monoclonal-antibody therapies
- Medications with significant cardiovascular or respiratory effects
- Medications with a boxed warning or significant risk of anaphylaxis/severe hypersensitivity
- High-dose or pharmacologically active electrolyte or metabolic therapies
- Investigational, off-label, or emerging IV therapies with limited safety data
These therapies carry a material risk of anaphylaxis, cardiovascular or respiratory compromise, or altered consciousness. Managing that risk safely requires hospital- or urgent-care-level capabilities — continuous cardiac monitoring, advanced airway management, ACLS-trained staff, immediate physician availability — that outpatient medical spas and wellness clinics are not equipped or licensed to provide.
NAD+ IV infusions specifically also carry FDA-flagged contamination and endotoxin risk from food-grade NAD+ compounding, are not FDA-approved for IV use, and are marketed almost entirely on unsupported wellness and anti-aging claims. Adverse events, including death, have been reported following NAD+ injectable products, and there is no medical reason to give NAD in IV form.
IV therapy is never marketed using unsupported claims, including "performance enhancer," "immunity boost," or disease-treatment claims. Every infusion has a documented clinical indication and a patient-specific order.
Offering IV Therapy?
This standard applies alongside the eight core Certification Requirements. If you have questions about how it applies to your practice, we're here to help.