Georgia rules for RF microneedling, body contouring and energy devices.
Practices that added RF microneedling or body contouring believing the laser rules did not reach them are working from an outdated read.
The short answer
Rule 360-35-.01 defines cosmetic laser services to include energy-based procedures using ultrasound, cryolipolysis, microwave, or radiofrequency devices that do not remove or burn the living skin surface but may damage underlying tissue if misused.
Who may perform them depends on whether the skin is broken. External energy treatments can be performed by a licensed assistant or senior laser practitioner, with an exam first. RF microneedling penetrates the skin and is a delegated medical act for an APRN or PA.
Who may perform which treatment
| Treatment | Who may perform it | Supervisor during treatment | Exam first? |
|---|---|---|---|
| RF, ultrasound, cryolipolysis, microwave (no needles) | ALP or SLP | On site or live by phone/video | Yes |
| RF microneedling | APP* only | Not required live — physician on call | Yes |
| Fractional CO2 / ablative resurfacing | APP* only | Not required live — physician on call | Yes |
| Microneedling with PRP or PRF | APP* only | Not required live — physician on call | Yes |
| Laser hair removal & IPL | ALP or SLP | On site or live by phone/video | No |
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* APP — nurse practitioner or physician assistant, performing a delegated procedure under a nurse protocol agreement or job description filed with, and accepted by, the Board. ALP / SLP — licensed assistant / senior laser practitioner.
Why RF microneedling has a looser live-supervision rule than a spider-vein laser
Laser and energy services run under Chapter 360-35, which supervises the service: Rule 360-35-.07(1)(d) requires a senior laser practitioner or consulting physician present or immediately available, including by telecommunications, during treatment.
Medical procedures delegated to an APP run under Chapter 360-32, which supervises the relationship: a filed protocol with a provision for immediate consultation, annual on-site observation, and quarterly record review — but no requirement that the physician be watching during the procedure. Two chapters, two logics. It is not a loophole.
The physician must be trained in the modality
Rule 360-35-.06(c) requires a consulting physician to be trained in laser modalities, including physics, safety, surgical technique, pre- and post-operative care, and the treatment of complications. A director overseeing energy devices should be able to produce those certificates on request.
How Local Medical Directors helps
Our device and laser rental program brings a laser or energy-based device into your practice with the safety program, operator training, and service coverage it requires, under a consulting physician trained in the modality.
Do Georgia's laser rules cover CoolSculpting and other cryolipolysis devices?
Yes. Rule 360-35-.01 defines cosmetic laser services to include energy-based procedures using cryolipolysis, as well as ultrasound, microwave, and radiofrequency devices that do not remove or burn the living skin surface but may damage underlying tissue if misused.
Who can perform RF microneedling in a Georgia med spa?
An APRN or PA working under a nurse protocol agreement or job description filed with and accepted by the Board, or a physician. RF microneedling penetrates the skin, so it is a delegated medical act under O.C.G.A. § 43-34-23 and outside laser practitioner scope.