Class 4 Laser Regulations

Regulations for Cold Laser Practitioners, Class 4 Laser Therapy & Clinics

Help with determining if the laws within your state allow for use of hot or cold laser therapy.

Following is a summary of the regional and special regulations for using hot and cold therapy lasers in a business. This resource is not 100% complete as the regulations can change periodically for each state. Consequently, it is advisable to check your local regulatory agencies to confirm that there are not further regulations. If you know of a regional requirement, please send us information so we can keep this page up to date and help everyone. You can use our contact form to send us an email.

Class4Lasers.com and Discover Lasers LLC and its publishers assume no responsibility for the accuracy of this information. It is provided as a courtesy for informational purposes only and the details can change at any time.
 

Here’s a **state-by-state overview of laws, rules, and regulations in the U.S. affecting the use of FDA-cleared Class 4 therapeutic lasers (e.g., Remy Laser and UltaLaser) by physical therapists, chiropractors, and non-practitioners (laser technicians, med-spa staff, etc.). This is a regulatory summary, meaning you will still need to confirm the specific statute or code with each state board or agency before relying on it in practice.

🇺🇸 Federal Law (Baseline Requirements)

FDA (Food and Drug Administration)

  • All Class 4 lasers marketed in the U.S. must be cleared by the FDA (510(k)) for specific therapeutic claims. U.S. Food and Drug Administration

  • The FDA regulates device safety labeling and performance standards (e.g., key switch, interlocks) for Class IIIb and Class IV devices. Wikipedia

  • The FDA does not regulate scope of practice (who may use the laser medically) — that is left to state law and professional boards.

📍 General Regulatory Themes by State

States generally fall into three broad regulatory categories for Class 4 therapeutic lasers:

Category 1 — Medical Director/Supervision Required (Most Restrictive)

A physician (MD/DO) or similar licensed medical professional must be involved, and non-medical personnel must operate under their supervision.

  • Connecticut, Delaware, Florida, Georgia, Hawaii, Indiana, Iowa, Maryland, New Jersey, New Mexico, Ohio, Oklahoma, Utah, Vermont, Virginia, etc.
    → A Medical Director or supervising physician must be assigned.
    → Only the supervising physician or delegates (PT/PA/RN under supervision) may provide laser therapy. Class 4 Lasers

  • New Jersey & North Carolina:
    → Only medical doctors (MD/DO) or specific physicians may personally provide Class 4 laser therapy — non-medicals are generally prohibited without physician delegation. Class 4 Lasers

Category 2 — Delegation to Licensed Providers / Certified Technicians

Class 4 laser therapy may be provided by licensed healthcare providers (PTs, DCs, RNs, PAs) or certified laser technicians with delegation/supervision.

  • Illinois, Nebraska, Pennsylvania, etc.
    → Clinic can be owned by non-medical professionals, but operations must be supervised by a Medical Director/physician or another licensed practitioner, and laser technicians must be properly trained/certified. 

  • Texas:
    → Must register Class 3B & Class 4 lasers with the Texas Department of State Health Services.
    → Use on humans requires supervision by a licensed healing arts practitioner and must be within that practitioner’s scope of practice.

Category 3 — Less Restrictive / No Specific Direct Supervision Mandate

States with fewer laser-specific supervision laws often defer to professional scope practice or radiation control guidelines:

  • New York:
    → No specific Class 4 laser therapy supervision laws published; non-medical professionals may operate in many contexts absent local restrictions. Class 4 Lasers

  • Oregon, Kansas, Rhode Island, etc.:
    → Non-medical professionals may own clinics; treatments must be supervised by an assigned Medical Director, but the director does not need to be on site. Class 4 Lasers

📜 Professional Scope of Practice Rules

Chiropractors:

  • Many states specifically require that chiropractors use only FDA-cleared lasers within their scope of practice, and prohibit medical/surgical or treatments outside that scope (e.g., treating allergies or performing non-neuromusculoskeletal procedures). Legal Information Institute

Physical Therapists:

  • PT scope of practice varies by state practice act but generally allows modalities (heat, light, laser) if within the PT domain (pain relief, rehabilitation). Laser supervision requirements depend on state practice rules and clinic regulations. Wikipedia

Non-Practitioners:

  • States with medical delegation laws require non-practitioner staff to be certified/lawfully delegated by a physician, PT, PA, or RN.

  • Some states (e.g., in the “medical director required” category above) allow non-medical operators only under supervision.

  • Laser safety training and clinic protocols are universally recommended, and in many states may be required by radiation safety boards or health departments.

🔧 Radiation Safety / Laser Registration Requirements

Even where professional boards don’t regulate scope of practice:

  • Many states require registration of Class 3B and Class 4 lasers with the state radiation control program or Department of Health (e.g., annual facility laser registration). rli.com

  • States often require written notification to the radiation control agency of possession/use of Class 4 lasers. rli.com

  • Laser safety officer (LSO) designation and adherence to ANSI/OSHA recommended standards are commonly expected (even if not strictly codified).

🧠 Key Points / Best Practices

✅ Always confirm with the state professional board (PT board, Chiropractic board, Medical board) — scope rules change frequently.
✅ Confirm state radiation control requirements — many states require laser registration, signage, eyewear safety protocols, and annual compliance. rli.com
✅ FDA clearance is mandatory for laser therapeutic use (laser must match its cleared indications). Legal Information Institute
✅ Understand the scope of practice for your license in each state — PTs and DCs have different duties allowed.
✅ Non-licensed personnel generally must operate under delegation/supervision and with documented training in states with medical delegation laws.

📌 Final Note

This overview is a high-level summary. Exact laws vary by state statute, administrative code, board rules, and radiation control regulations. You or your legal counsel should confirm specific statutes and agency rules directly with relevant state boards or departments of health for authoritative compliance.

There are 3 primary types of limitations on laser therapy businesses:

1. Advertising Limitations. The FDA regulates advertising of laser therapy devices. They can only be advertised for FDA cleared application. For therapeutic lasers, the most common FDA clearances are for pain relief, inflammation reduction and increasing blood circulation. Some folks are advertising for other applications, and if the laser is not cleared such an application, they are taking a risk that someone does not report them.

2. Insurance Limitation: Any laser therapy business should have insurance in case someone sues the business. Some insurance companies only allow the use of FDA cleared devices on humans, so everyone should check with their agent.

3. Local regulation. Many state and some professions have limited information available about who can use a laser and what type of records must be kept for the care of humans. Some states also regulate the use of lasers on animals.

Table of Contents for Each US State:

U.S. Laser Therapy Requirements

There are several layers of regulations and requirement in the United States. At the national level, the 2 main requirement are on the sale and advertising of lasers:

  • Class 1 and Class 2 Therapy Lasers: Class 1 and 2 laser systems are OTC (over the counter) with no restrictions on anyone. 
  • Class 3 Therapy Lasers: These can be SOLD to ANY health care practitioner and they can be sold for home use with a recommendation/prescription from a health care practitioner. This requirement is on the manufacturer and not the buyer. Some legitimate international companies and most fly-by-night companies do not comply with this requirement. Thus it is advisable to purchase lasers from a reputable company who has been in business for at least 5-10 years.
  • Legitimate advertising is limited to services using laser therapy for pain control, inflammation reduction, or increasing blood circulation. 
  • Class 4 Therapy Lasers: Class IV Therapy Lasers can be SOLD to ANY health care practitioner and they can be sold for home use with a recommendation/prescription from a health care practitioner. This requirement is on the manufacturer and not the buyer. 
  • Class 4 Therapy Lasers for Animals: Class IV Therapy Lasers can also be sold to non-professionals for the intended application of treating small and large animals such as dogs and horses. They are popular with Veterinary clinics, animal hospitals and equine treatment stables.
  • In many states, practitioners who use Class 4 therapy lasers are only allowed to do so with Class 4 Lasers that are FDA/510k cleared. 
  • A good number of Class 4 lasers are FDA cleared for Pain Relief, but very few lasers have the additional clearance that REMY Lasers have achieved, which expands use to a wider range of practitioners. REMY Class 4 lasers are FDA cleared for pain relief, inflammation reduction and can also be advertised for toenail fungus and wart removal. These are important distinctions, because, treatment modalities must be included in a practitioners scope of practice, and someone who is misrepresenting their health care service by offering services not included in their scope, can be fined or loose their license. Thus, always make sure that your chosen laser has FDA/510k Clearance.

U.S. Regional Regulations for Businesses

In addition to the national FDA requirement, some states have created laws to support special interest groups, stifle competition and hold back usage of cold laser market. Many of the restriction on class 4 laser were lobbied for by class 1, 2 and 3 manufacturers that did not want the competition. Some regulations were created to make sure that only one small group can financially benefit from laser technology. These regulations will slow down the adoption and wider usage of lasers but compliance is critical component of every business. These regulations are based on the type of patient (human or animal) and the class of the laser.

Special Requirement for Class 4 Lasers
Class 4 lasers are the most restricted group of lasers. They have additional requirements in many states. The level of regulation can be be grouped into 3 basic categories. Use these categories, the list below and definition (below the table) as a general guideline to state-by-state special regulations.

Class 4 Laser – Category 1 State Requirements

  • Physician Oversight Not Required
  • Nonmedical Personnel May Own Clinic
  • Medical Director May or May Not Be On-Site
  • Laser therapy may be provided by nonmedical personnel

Class 4 Laser – Category 2 State Requirements

Physician Oversight Is Required – Medical Doctors May Delegate Non-medical Professionals under Their Individual State License to Provide Laser Therapy

Class 4 Laser- Category 3 State Requirements

Only Physicians and Medical Doctors May Provide Laser Therapy Treatments (in some cases they may be able to delegate a Physician’s Assistant (PA), Registered Nurse (RN), or other Medical Doctor to provide treatments. Some exceptions may apply, (according to specific state guidelines, additional rules may also apply). For example, deep within the scope of practice documentation for Chiropractors and Physical Therapists, you can often find the sentence, “…. are not allowed to use lasers that are not approved by the FDA.” This suggests that if the non-invasive, therapeutic laser is FDA cleared, that it can be used in practice.

Alabama

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

Alaska

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

Arizona

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1, additional rules apply): Class 4 Human Patient Requirements: Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by a Medical Director who is a health care practitioner but does not need to be on-site, and treatments may be provided by other non-medical professionals who are certified by the clinic’s Medical Director. State requirements for appropriate training and certification are regulated by the Arizona State Board of Radiation.

Arkansas

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

California

  • Class 3 Humans: No additional restrictions
  • Class 4 Animals: In California, only licensed veterinarians (DVMs) or registered veterinary technicians (RVTs) under direct supervision may use Class 4 therapeutic lasers on animals for pain relief, musculoskeletal rehabilitation, and soft tissue repair, per the Veterinary Medicine Practice Act (BPC §§ 4800–4854). These lasers treat conditions like joint rehab, and chronic pain but require a valid Veterinary-Client-Patient Relationship (VCPR) established via recent exam or telehealth (BPC § 4826.6). Non-veterinarians, including animal trainers, cannot practice laser therapy professionally.

    All Class 4 laser devices must be registered with the California Department of Public Health’s Radiologic Health Branch within 30 days (Title 17 CCR §§ 30175–30358). Facilities must appoint a Laser Safety Officer, provide eye protection, and follow ANSI Z136.3 safety standards. Veterinarians should have some training on laser protocols and document informed consent and treatment parameters to meet standards of care.

  • Class 4 Humans: Non-medical professionals may own a Class 4 laser therapy clinic; in this case, laser therapy treatment must be supervised by a Medical Doctor who does not need to be on-site. The clinic’s Medical Director may supervise treatment, but acts under the supervision of the Medical Doctor. Other Health care Practitioners may provide laser therapy treatments under the regulations and scope of practice of their respective professions.
  • Chiropractors, Medical Doctors and Doctors of Orthopedic Medicine in California are not allowed to use lasers that are not approved by the FDA. FDA Cleared/510k Class 4 therapy lasers can be used in conjunction with other treatments, such as physical therapy, chiropractic care, and medication management. Class 4 laser therapy is allowed as long as the laser used is FDA/510k Cleared Such as with Remy and UltaLaser brands and as long as the laser is used for pain, rehab and other issues within the scope of practice.
  • Physical Therapists: Based on current California law (as of October 2025, incorporating updates through the 2024 legislative session), Physical Therapists (PTs) in California do not need to appoint a medical director or physician to use Class 4 therapeutic lasers for pain relief, rehabilitation, musculoskeletal conditions, or similar applications. This falls squarely within the PT scope of practice as a licensed healthcare professional, without requiring physician supervision or delegation for therapeutic (non-aesthetic) use. Below, I’ll break this down with key details, drawing from the Physical Therapy Practice Act and related resources.

    1. Scope of Practice for PTs and Therapeutic Lasers

    • California’s Physical Therapy Practice Act (Business and Professions Code §2620) explicitly defines physical therapy to include “the use of the physical, chemical, and other properties of heat, light, water, electricity, sound, massage, and active, passive, and resistive exercise” for rehabilitation and treatment of bodily conditions. Class 4 lasers (high-power, >0.5W output) qualify as a light-based therapeutic modality, used for deep tissue penetration to reduce inflammation, promote tissue repair, relieve acute/chronic pain, and support rehab—aligning with PT interventions like those for neuropathy, joint rehab, fibromyalgia, spine rejuvenation, or no-needle acupuncture.
    • PTs have direct access authority (since AB 1701 in 2014) to evaluate, diagnose movement dysfunctions, and provide treatments without a physician referral or supervision for most cases (up to 45 days of care, with exceptions for certain chronic conditions). This extends to modalities like lasers; no MD oversight is mandated for operation within PT licensure.
    • Evidence of widespread use: Numerous CA PT clinics (e.g., in Irvine, Playa Vista, Manhattan Beach) routinely offer Class IV laser therapy for sports injuries, post-surgical recovery, and chronic pain, with no reported regulatory barriers tied to physician involvement.

    2. No Medical Director or Physician Supervision Required

    • Unlike aesthetic laser procedures (e.g., hair removal, skin resurfacing under med spa rules in §501.122 or Medical Board guidelines), therapeutic Class 4 lasers are not classified as “surgery” or requiring delegation. PTs operate independently as autonomous practitioners for rehab modalities. Resources like the American Society for Laser Medicine and Surgery (ASLMS) laser regulations guide confirm no state-specific PT supervision for non-ionizing therapeutic lasers.
    • The class4lasers.com summary you might encounter (often blending categories) applies mainly to non-medical professionals (e.g., clinic owners without healthcare licensure) for Category 2 devices, requiring MD supervision. As a licensed PT, your customer is exempt—this is a healthcare provider role, not a delegated task.
    • PTAs (assistants) can assist under PT supervision (max 2:1 ratio), but the PT must oversee laser application per Title 16 CCR §1398.95.

    3. Device Registration and Safety Requirements

    • CDPH Radiologic Health Branch Registration: Class 4 lasers must be registered with the California Department of Public Health (CDPH) as “laser use facilities” under Title 17 CCR §30175–30358 (non-ionizing radiation safety). This is for hazard prevention (e.g., eye/skin protection), not clinical authorization:
      • Register within 30 days of acquisition (online via CDPH portal; ~$100 fee).
      • Appoint a Laser Safety Officer (can be the PT owner), train staff, and maintain safety protocols (e.g., ANSI Z136.1 compliance, warning signs).
      • Renew annually; inspections rare unless incidents occur.
    • FDA Clearance: Ensure the device is FDA-cleared (510(k)) for therapeutic claims (e.g., temporary pain relief, circulation improvement)—standard for reputable Class 4 systems like REMY or Ulta.

    4. Training and Continuing Education

    • No state-specific hours mandated for lasers, but PTs must stay competent via general CEUs: 30 units biennially (Title 16 CCR §1399.90–1399.99), which can include laser training (e.g., manufacturer courses on dosing for rehab protocols).
    • Remy laser training includes certification and CME credits.

    5. Other Considerations for Your PT Practice

    • Liability and Documentation: PTs are fully responsible; obtain informed consent, chart parameters (e.g., wavelength, joules/cm²), and align with evidence (e.g., studies showing 20–30% faster recovery in musculoskeletal cases). No physician protocols needed unless billing insurance requires it.
    • Business Integration: This expands services (e.g., drug-free pain management, boosting retention/revenue). Pair with bundles like shockwave for comprehensive rehab—market as “FDA-cleared, non-invasive” with 5-year warranties on select devices.
    • Updates Check: No 2024–2025 changes impact this (per PTBC 2025 Law Guide); AB 1458 (2025) modernizes practice but doesn’t alter modalities. Verify via PTBC (916-561-8200) for her setup.
    • Resources:

Colorado

  • Class 3 Humans: Same as Class 4 listed below
  • Class 4 Humans (Category 1, additional rules apply): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director1 who should be a Health care Practitioner and laser therapy treatments may be provided by other non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser. (Note: Colorado has revised their standards under Rule 800; state guidelines for appropriate training and certification are supervised by the Department of Higher Education, Health Occupations.)
  • Equine: Only licensed veterinarian can use a laser on horses as part of a business.

Connecticut

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2, additional rules apply): Only medical doctors may delegate non-medical professionals under their individual state license to provide laser therapy. The delegating physician is responsible for actions of the Medical Director in the Clinic, and must provide adequate supervision. It is up to the physician whether the supervision is direct or indirect, and whether the physician is on-site or off-site. Other medical practitioners such as a PT, RN, LPN, EMT, etc. must work directly under the medical supervision and licensure of a medical doctor; the clinic’s Medical Director must be on site.

Delaware

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 3, additional rules apply): Only medical doctors may delegate non-medical professionals under their individual state license; the physician is responsible for their activities and must provide adequate supervision. It is up to the physician whether the supervision is direct or non-direct. The physician must personally evaluate any patient at least every three months.

Florida

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 3, additional rules apply): Only medical doctors may delegate non-medical professionals under their Florida license to provide laser therapy. The delegating physician is responsible for actions of the Medical Director in the Clinic, and must provide adequate supervision. It is up to the physician whether the supervision is direct or indirect, and whether the physician is on-site or off-site. Chiropractors and Physical Therapists:

    In Florida, licensed chiropractors (DCs) and physical therapists (PTs) may independently use Class 4 therapeutic lasers for pain relief, musculoskeletal rehabilitation, and soft tissue repair within their respective scopes of practice, without requiring delegation or supervision from a medical doctor (MD). DCs and PTs are responsible for ensuring their use aligns with evidence-based protocols and professional licensure standards. No on-site medical director is required for therapeutic laser use in their clinics. Other healthcare practitioners, such as athletic trainers (ATs), may use Class 4 lasers under written or oral protocols from a licensed physician (MD, DO, or DPM), which can be off-site, but no on-site medical director is mandated. Non-licensed professionals may not operate Class 4 lasers unless specifically trained and supervised by a licensed DC, PT, or AT within their scope, and such delegation is limited. All Class 4 laser devices must be registered with the Florida Department of Health’s Bureau of Radiation Control, and facilities must appoint a Laser Safety Officer to ensure compliance with safety protocols (e.g., eye protection, warning signs).

  • Athletic Trainers:
    Information on Regulations for Therapeutic Class 4 Lasers in Florida
    1. Scope of Practice for Athletic Trainers
    • Licensed athletic trainers (ATs) in Florida can use Class 4 therapeutic lasers for pain relief, rehab, and musculoskeletal treatment, as this qualifies as a therapeutic modality involving “light” properties (e.g., infrared light for deep tissue penetration).
    • Under Florida Statute §468.705 and Rule 64B33-1.003:
      • ATs may apply therapeutic agents with properties of light (e.g., infrared, ultraviolet) for treatment and rehabilitation of injuries.
      • Examples include reducing inflammation, promoting tissue repair, and managing acute/chronic pain—aligning with Class 4 laser benefits like neuropathy relief, joint rehab, fibromyalgia, spine rejuvenation, and no-needle acupuncture.
      • ATs must operate under the direction of a licensed physician (MD, DO, or DPM) via oral/written protocols or prescriptions. This can be indirect/off-site; no on-site medical director is required for therapeutic use.
    • Your customer (as an AT and facility owner) can own and operate the laser in his training facility, provided he holds an active Florida AT license. Non-licensed staff cannot perform treatments unless delegated under AT supervision (but delegation is limited to AT scope).
    • Evidence of Use: Class 4 lasers are commonly used by ATs in Florida for sports rehab (e.g., NFL/MLB trainers), with no reported restrictions beyond general scope.
    2. Device Registration and Safety Requirements
    • All Class IV lasers (output ≥0.5 watts) must be registered with the Florida Department of Health’s Bureau of Radiation Control within 30 days of acquisition/use. This is for safety (e.g., preventing burns or eye damage), not who can operate it therapeutically.
      • Registration is per device/facility; fee ~$100 initially, $50 renewal. Exemptions apply to lower classes, but not Class 4.
      • Facilities must appoint a Laser Safety Officer, post warnings, and train users on hazards (e.g., eye protection).
    • Registration does not authorize medical use—that’s governed by the practitioner’s license (e.g., AT Board).
    3. Training and Certification
    • No state-mandated training specifically for therapeutic Class 4 lasers (unlike aesthetics, which requires 30+ hours via electrology programs).
    • Recommended: Manufacturer-provided training (e.g., 8-16 hours on protocols, dosing for pain/rehab). ATs must complete 24 CEUs biennially, which can include laser modalities.
    • For facility staff: Ensure protocols align with physician direction; document informed consent for treatments.
    4. Physician Involvement and Liability
    • A consulting physician is needed for protocols (e.g., treatment parameters for rehab). This can be remote; no 30-minute response rule applies (that’s aesthetic-specific).
    • The AT/owner is liable for treatments within scope; physician oversees protocols but isn’t directly responsible unless delegating beyond AT limits.
    5. Other Considerations for Your Customer’s Facility
    • FDA Clearance: Emphasize devices are FDA-cleared for temporary relief of minor muscle/joint pain, arthritis, and improved circulation—key for marketing to athletes.
    • Integration: Pairs well with shockwave therapy; no specific regs, but ensure combined protocols are physician-approved.
    • Business Setup: As a non-medical facility, no “medical director” needed, but partner with a local MD for protocols to build trust/revenue (e.g., referrals for complex cases).
    • Risks: Unlicensed use is a misdemeanor; always verify with Florida Board of Athletic Training (850-245-4356) for case-specific advice.
    • Resources:
  • Non-medical licensed Electrologists may own a Class 4 laser therapy clinic and provide laser therapy treatments in the state of Florida; supervision must be provided by a Medical Director who is a health care practitioner but does not need to be on-site, and treatments may be provided by other non-medical professionals who are certified by the clinic’s Medical Director. A medical doctor must be 30 minutes away or less, and must be available to respond to medical needs within a 30-minute window. State requirements for appropriate training are supervised by the Florida State Electrology Association. (Note: Electrology is the practice of electrical epilation to permanently remove human hair; the process of removing the hair is referred to as electrolysis.)

Georgia

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

Hawaii

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 3, additional rules apply): In Hawaii, licensed chiropractors (DCs) and physical therapists (PTs) may independently use Class 4 therapeutic lasers for pain relief, musculoskeletal rehabilitation, and soft tissue repair within their scope of practice, without requiring delegation or supervision from a medical doctor (MD). DCs (per HRS §442-1) and PTs (per HRS §461J-1) can apply lasers for conditions like neuropathy, joint rehabilitation, fibromyalgia, and spine rejuvenation, provided they follow evidence-based protocols and maintain professional licensure standards. Other healthcare practitioners, such as athletic trainers (ATs), may use Class 4 lasers under written or oral protocols from a licensed physician (MD or DO), which can be off-site; no on-site medical director is required. Non-licensed professionals may not operate Class 4 lasers unless specifically trained and supervised by a licensed DC, PT, or AT within their scope, and such delegation is limited. All Class 4 laser devices must be registered with the Hawaii Department of Health’s Radiologic Technology Board as non-ionizing radiation sources, with facilities appointing a Laser Safety Officer to ensure compliance with safety protocols (e.g., eye protection, warning signs).

Idaho

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified3 in the use of the laser.

Illinois

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2, additional rules apply) : Non-medical professionals may own a Class 4 laser therapy clinic; laser therapy treatment MAY be supervised by a medical doctor who does not need to be on-site. The clinic’s Medical Director, who must be a licensed health care practitioner, supervises treatment. Other Health care Practitioners, such as a PT, PA, RN, LPN, massage therapist, or certified laser therapy technician may provide laser therapy treatments and act under the supervision of the Medical Director.

Indiana

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 3, additional rules apply): Physicians may delegate non-medical professionals under their individual state license to provide laser therapy. The delegating physician is responsible for actions of the Medical Director in the Clinic, and must provide adequate supervision. It is up to the physician whether the supervision is direct or indirect, and whether the physician is on-site or off-site. Other medical practitioners such as a PT, RN, LPN, EMT, etc. must work directly under the medical supervision and licensure of a medical doctor; the clinic’s Medical Director must be on site.

Iowa

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 3, additional rules apply): Physicians, RNs, PAs, in addition to Electrologists, Aestheticians, and Cosmetologists, may provide laser therapy treatments, and delegate trained and certified non-medical professionals under their individual state licenses to provide laser therapy; a Medical Director is required and must be a Health care Practitioner. The delegating physician is responsible for actions of those operating under their license, and must provide adequate supervision. It is up to the physician whether the supervision is direct or indirect, and whether the physician is on-site or off-site.

Kansas

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

Louisiana

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

Maine

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 3): Physicians can delegate a PA or an RN under their individual state license to provide laser therapy; a Medical Director is required and must be a Health care Practitioner. The delegating physician is responsible for actions of those operating under their license, and must provide adequate supervision. It is up to the physician whether the supervision is direct or indirect, and whether the physician is on-site or off-site.

Maryland

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2): Physicians, PAs, and RNs, can delegate trained and certified non-medical professionals such as laser therapy technicians under their individual state license to provide laser therapy; however the physician, PA, or RN responsible for their activities and must provide adequate supervision. It is up to the Physician, PA, or RN, whether the supervision is direct or non-direct.

Massachusetts

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 3): Nonmedical professionals may own a laser therapy clinic, but laser therapy must be provided directly by a physician, or by a medical professional operating directly under a physician’s supervision. The physician dictates whether the supervision will be on-site.

Michigan

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

  • In Michigan, physical therapists (PTs) can use Class IV therapeutic lasers (also known as high-intensity or high-power therapy lasers) as part of their practice, provided the use falls within their scope of practice and follows general safety guidelines. Here’s a clear breakdown based on current regulations as of December 2025:

    Scope of Practice for Physical Therapists in Michigan

    Michigan’s Public Health Code (Part 178, MCL 333.17801 et seq.) defines physical therapy broadly as the use of physical measures, agents, and modalities to evaluate, prevent, alleviate, or correct impairments, functional limitations, and disabilities. This includes modalities like light-based therapies (e.g., photobiomodulation or laser therapy) for pain management, inflammation reduction, and tissue healing.

    • No explicit prohibition exists on Class IV lasers in the Michigan Board of Physical Therapy rules or administrative code (R 338.7101 to R 338.7163).
    • Therapeutic lasers are commonly used by PTs in Michigan clinics for musculoskeletal conditions, and many practices (including PT-owned ones) offer Class IV laser therapy as a standard modality.

    Key Requirements and Guidelines

    1. FDA Clearance: Class IV therapy lasers must be FDA-cleared for the intended use (e.g., pain relief, inflammation reduction). Most reputable systems like the REMY FX Elite series are FDA 510(k)-cleared for these indications.
    2. Training and Competence: PTs must be properly trained in the safe operation of the laser. This typically includes manufacturer-provided certification, which is standard with purchases from reputable vendors like Class4Lasers.com. The Michigan Board emphasizes that licensees must practice within their education, training, and competence.
    3. Supervision/Delegation:
      • Licensed PTs can perform laser therapy independently.
      • If delegating to a physical therapist assistant (PTA), the PT must provide general supervision (not necessarily on-site, but available for direction).
      • Delegation to unlicensed staff requires direct on-site supervision.
    4. No Physician Referral Required for Most Cases: Michigan allows direct access for PTs—patients can receive up to 21 days or 10 visits of treatment without a physician referral (whichever comes first). Laser therapy falls under this for evaluation and treatment.
    5. Safety Compliance: Follow FDA laser safety guidelines (e.g., protective eyewear, “Laser in Use” signs) and any facility-specific protocols. Class IV lasers are considered safe when used by trained professionals.

In Michigan, chiropractors are permitted to use Class IV therapeutic lasers (high-intensity or high-power therapy lasers) as part of their practice. This falls within their defined scope under the Public Health Code.

Scope of Practice for Chiropractors in Michigan

Michigan’s Public Health Code (Article 15, Part 164, MCL 333.16401) defines the “practice of chiropractic” broadly as a discipline dealing with the nervous system and musculoskeletal system. It explicitly includes:

  • Chiropractic adjustments for subluxations, misalignments, and joint dysfunction.
  • The use of physical measures, analytical instruments, nutritional advice, rehabilitative exercise, and adjustment apparatus (regulated by board rules under MCL 333.16423).

“Physical measures” encompasses therapeutic modalities like light-based therapies (e.g., photobiomodulation or laser therapy) for pain relief, inflammation reduction, and tissue healing. No explicit prohibition exists on Class IV lasers in the Michigan Board of Chiropractic rules or the Public Health Code.

Many chiropractic clinics in Michigan routinely offer Class IV laser therapy for musculoskeletal conditions, and the Board approves continuing education courses on laser therapy (categorized under “physical measures”).

Key Requirements and Guidelines

  1. FDA Clearance — The laser must be FDA-cleared (e.g., 510(k)) for intended uses like temporary pain relief and increased circulation. Reputable systems like the REMY FX Elite series meet this standard.
  2. Training and Competence — Chiropractors must be trained and competent in safe operation. Manufacturer-provided certification (included with purchases from vendors like Class4Lasers.com) is standard and recommended. The Board requires practice within your education and training.
  3. Supervision/Delegation — Licensed chiropractors can perform laser therapy independently. Delegation to staff (if any) must follow general supervision rules.
  4. Safety Compliance — Follow FDA laser safety standards: Use protective eyewear, post “Laser in Use” signs, and adhere to protocols. Class IV lasers are safe when operated by trained professionals.
  5. Limitations — Therapy must align with chiropractic scope (non-invasive, no cutting/puncturing skin, no prescribing drugs except diagnostically). Ablative or surgical lasers are not allowed.

Recommendations for Compliance

  • Document your training and certification.
  • Stay current with Board-approved CE (laser topics often qualify under “physical measures”).
  • For specific applications or doubts, contact the Michigan Board of Chiropractic directly via michigan.gov/lara > Bureau of Professional Licensing > Chiropractic.

Chiropractors across Michigan successfully integrate Class IV lasers (e.g., REMY FX Elite models) to improve patient outcomes, accelerate healing, and grow their practices—without needing additional state licensure beyond your chiropractic credential.

Minnesota

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified3 in the use of the laser.

Mississippi

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

Missouri

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director1 who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

Montana

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2): Physicians, PAs, and RNs can delegate trained and certified non-medical professionals under their individual state licenses to provide laser therapy; the physician, PA, or RN responsible for their activities and must provide adequate supervision. A Medical Director is required, and must be a Physician, PA, or RN. It is up to the Physician, PA, or RN whether the supervision is direct or indirect, and the Medical Director must be on-site.

Nebraska

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2): Non-medical professionals may on a Class 4 laser therapy clinic; Physicians can delegate non-medical professionals to provide laser therapy as long as they are properly trained and certified. The Physician is the de facto Medical Director and makes all decisions regarding laser therapy treatment and who provides it.

Nevada

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

New Hampshire

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2): Physicians can delegate non-medical professionals to provide laser therapy as long as they are properly trained and certified. A Medical Director is required; all operate under the Physician’s license and supervision. It is up to the Medical Director whether the supervision is direct or indirect, the Medical Director must be on-site.

New Jersey

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 3): Chiropractors, Medical Doctors and Doctors of Orthopedic Medicine in New Jersey are not allowed to use lasers that are not approved by the FDA. FDA Cleared/510k Class 4 therapy lasers can be used in conjunction with other treatments, such as physical therapy, chiropractic care, and medication management. 

New Mexico

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2, additional rules apply): Physicians, PAs, and RNs can delegate trained and certified non-medical professionals such as Certified Laser Therapy Technicians, Cosmetic Therapists, or Electrologists under their individual state license to provide laser therapy; however, the physician, PA, or RN responsible for their activities and must provide adequate supervision. A Medical Director is required, and must be a Physician, PA, or RN. It is up to the Physician, PA, or RN whether the supervision is direct or indirect, and the Medical Director must be on-site.

New York

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans

    As of February 2026, New York State has no specific, standalone regulations or guidelines exclusively for class 4 laser therapy (high-powered therapeutic lasers used for pain management, rehabilitation, or non-ablative tissue effects in medical contexts like chiropractic, physical therapy, or veterinary applications). However, recent developments from the New York State Board for Medicine and the New York State Education Department significantly impact how these devices are treated, particularly when used to treat “physical conditions” involving deeper tissues.

    Key Current Guidance (March 2025 Ruling)

    On March 7, 2025, the New York State Board for Medicine determined that the use of energy devices, including lasers, which affect the basement membrane or deeper tissues (e.g., dermis, fat, or subepidermal layers) to treat any physical condition constitutes the practice of medicine under Section 6521 of the New York State Education Law. This includes many therapeutic class 4 laser applications for pain relief, inflammation reduction, or tissue healing, as these devices are classified as Class IV (high-powered, capable of significant subepidermal tissue damage or effects).

    • Exclusions: Laser hair removal is specifically carved out and not considered the practice of medicine (based on longstanding precedent like People v. Lehrman).
    • Class IIIb and Class IV Devices: These are explicitly medical. Class IIIb includes “medium-powered devices for therapeutic purposes” (e.g., some non-ablative therapeutic lasers for pain management affecting the upper dermis). Class IV covers high-powered devices affecting deeper layers.
    • Who May Perform/Operate:
      • Exclusively licensed medical professionals (physicians, physician assistants, or nurse practitioners) for Class IV.
      • Licensed medical professionals or supervised personnel for Class IIIb.
      • Non-medical professionals (e.g., aestheticians or unlicensed individuals) are prohibited from operating these for deeper-tissue therapeutic uses.
    • Supervision and Delegation: Treatments must be conducted by or under the order of a licensed physician, PA, or NP. Registered nurses (RNs) may execute orders under general supervision, but non-licensed personnel cannot perform them independently.
    • Ownership of Clinics: While non-medical professionals may own a business offering such services in some contexts, providing the therapy itself falls under medical practice rules. Clinics offering class 4 laser therapy for physical conditions must comply with corporate practice of medicine (CPOM) restrictions—typically requiring physician ownership or oversight (e.g., via a Professional Corporation). Non-medical ownership without proper medical integration risks enforcement for unauthorized practice of medicine.

    This 2025 guidance overrides or updates older informal sources (like those stating “no rules established” for class 4 human therapy), as it adopts a broader classification system for energy devices.

    Other Relevant Regulations

    • General Laser Safety (Non-Medical/Industrial): New York Department of Labor’s 12 NYCRR Part 50 (Laser Regulation) applies to industrial, research, or non-healing uses. It requires registration of laser installations, designation of a Laser Safety Officer (LSO), personal protective equipment, and compliance with maximum permissible exposure limits. It exempts lasers used in human healing under medical supervision and animal healing under veterinary supervision.
    • FDA Oversight: All class 4 lasers are regulated federally as medical devices (often requiring 510(k) clearance for therapeutic claims). They must comply with performance standards (21 CFR Part 1040), including labeling warnings like “LASER RADIATION – AVOID EYE OR SKIN EXPOSURE TO DIRECT OR SCATTERED RADIATION” for Class IV.
    • No Specific State Certification for Therapeutic Use: Unlike some states, New York does not have a dedicated certification for class 4 therapy laser operators in non-cosmetic contexts (e.g., no mandatory LSO registration for healthcare unless in regulated facilities). However, facilities using class 3B/4 lasers often follow ANSI Z136.3 standards for safe use in health care, recommending hands-on training.

    Practical Implications for Class4Lasers.com Customers in NY

    • Non-Medical Professionals: Cannot independently provide class 4 laser therapy for treating physical conditions (e.g., pain in chiropractors, PTs, vets) without medical oversight, as it risks being unlicensed practice of medicine (a felony under Education Law §6512).
    • Licensed Practitioners: Chiropractors, physical therapists, podiatrists, etc., may use class 4 lasers within their scope if under appropriate medical supervision or if the treatment doesn’t cross into restricted medical practice. However, high-powered therapeutic use often requires physician/PA/NP involvement.
    • Enforcement Trends: Recent crackdowns (e.g., 2025 med spa investigations) show increased scrutiny on energy devices without proper licensing/oversight.

North Carolina

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 3): Chiropractors, Medical Doctors and Doctors of Orthopedic Medicine in North Carolina are not allowed to use lasers that are not approved by the FDA. FDA Cleared/510k Class 4 therapy lasers can be used in conjunction with other treatments, such as physical therapy, chiropractic care, and medication management. 

North Dakota

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2, additional rules apply): Non-medical professionals may own a Class 4 laser therapy clinic; Physicians can delegate non-medical professionals to provide laser therapy as long as they are properly trained and certified. The Physician is the de facto Medical Director and makes all decisions regarding laser therapy treatment and who provides it.

Ohio

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2, additional rules apply): Physicians, PAs, and RNs can delegate trained and certified3 non-medical professionals such as Certified Laser Therapy Technicians, Cosmetic Therapists, or Electrologists under their individual state license to provide laser therapy; the physician, PA, or RN is responsible for their activities and must provide adequate supervision. A Medical Director1 is required, and must be a Physician, PA, or RN. It is up to the Physician, PA, or RN whether the supervision is direct or indirect, and the Medical Director1 may or may not be on-site.

Oklahoma

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2, additional rules apply): Non-medical professionals may own a Class 4 laser therapy clinic; Physicians can delegate nonmedical professionals to provide laser therapy as long as they are properly trained and certified. The Physician is the de facto Medical Director1 and makes all decisions regarding laser therapy treatment and who provides it.

Oregon

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director1 who should be a Health Care Practitioner4 and laser therapy treatments may be provided by nonmedical professionals under the supervision of the clinic’s Medical Director1 who does not need to be on-site. It is recommended that a Laser Safety Officer2 (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified3 in the use of the laser.

Pennsylvania

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2): Non-medical professionals may own a Class 4 laser therapy clinic; Physicians can delegate nonmedical professionals to provide laser therapy as long as they are properly trained and certified3. The Physician is the de facto Medical Director1 and makes all decisions regarding laser therapy treatment and who provides it.

Rhode Island

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director1 who should be a Health Care Practitioner4 and laser therapy treatments may be provided by nonmedical professionals under the supervision of the clinic’s Medical Director1 who does not need to be on-site. It is recommended that a Laser Safety Officer2 (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified3 in the use of the laser.

South Carolina

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified3 in the use of the laser.

South Dakota

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2): Non-medical professionals may own a Class 4 laser therapy clinic; only Physicians can delegate non-medical professionals to provide laser therapy as long as they are properly trained and certified. The Physician is the de facto Medical Director and makes all decisions regarding laser therapy treatment and who provides it.

Tennessee

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2): Non-medical professionals may own a Class 4 laser therapy clinic; only Physicians can delegate non-medical professionals to provide laser therapy as long as they are properly trained and certified. The Physician is the de facto Medical Director and makes all decisions regarding laser therapy treatment and who provides it. Electrologists can provide laser treatments without Physician supervision.

Texas

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1; additional rules apply): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health care Practitioner and laser therapy treatments may be provided by other non-medical professionals under the supervision of the clinic’s Medical Director1 who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser. A State certificate is required for laser electrolysis procedures; all procedures must be supervised by the Medical Director.
  • Equine: Only licensed veterinarian can use a laser on horses as part of a business.

Utah

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2): Non-medical professionals may own a Class 4 laser therapy clinic; physician oversight is required for laser therapy treatments. Only Physicians can delegate non-medical professionals to provide laser therapy as long as they are properly trained and certified. The Physician is the de facto Medical Director1 and makes all decisions regarding laser therapy treatment and who provides it.

Vermont

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director1 who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified3 in the use of the laser.

Virginia

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2): Non-medical professionals may on a Class 4 laser therapy clinic; physician oversight is required. Only Physicians can delegate nonmedical professionals to provide laser therapy as long as they are properly trained and certified. The Physician is the de facto Medical Director and makes all decisions regarding laser therapy treatment and who provides it.

Washington

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 2; additional rules apply): Non-medical professionals may own Class 4 laser therapy clinic; however, only physicians, PAs Doctors of Naturopathic Medicine, or a Licensed Aesthetician can operate the laser. A Physician or Physician’s Assistant (PA) must oversee consultation and treatment, a PA can provide therapy laser treatments or delegate procedures to properly certified and trained nonmedical personnel, and must be on site.

West Virginia

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

Wisconsin

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

Wyoming

  • Class 3 Humans: No additional restrictions
  • Class 4 Humans (Category 1): Non-medical professionals may own a Class 4 laser therapy clinic and provide laser therapy treatments; supervision must be provided by an assigned Medical Director who should be a Health Care Practitioner and laser therapy treatments may be provided by non-medical professionals under the supervision of the clinic’s Medical Director who does not need to be on-site. It is recommended that a Laser Safety Officer (LSO) be assigned to carry out LSO duties, and that all clinic personnel be trained and certified in the use of the laser.

Massage Therapists (LMTs) Using Class 4 Therapeutic Lasers

  • Licensed massage therapists (LMTs) in the United States can potentially incorporate Class 4 therapeutic lasers (high-power, >0.5W devices for non-invasive pain relief, inflammation reduction, and tissue repair) into their practice, but regulations are strictly state-specific and tied to the scope of massage therapy. The scope typically includes soft tissue manipulation and adjunctive modalities (e.g., heat, light, or electrical stimulation), but Class 4 lasers—used for applications like acute/chronic pain relief, neuropathy, joint rehab, fibromyalgia, spine rejuvenation, no-needle acupuncture, and musculoskeletal/soft tissue repair—may require additional training, physician oversight, or fall outside scope in conservative states. Always verify with your state board, as unlicensed use can result in fines or license revocation.

    The American Massage Therapy Association (AMTA) does not have a specific position statement on therapeutic lasers but emphasizes practicing within state-defined scope to ensure safety and legality. Adding lasers can enhance patient outcomes (e.g., 20-30% faster recovery in musculoskeletal cases per clinical studies), boost retention, and increase clinic revenues by expanding to drug-free pain management services—complementing chiropractic or PT practices for integrated care.

    Key Considerations Across States

    • Scope of Practice: In most states, lasers qualify as a “light-based” or “thermal” modality if non-ablative (therapeutic, not surgical/cosmetic). However, some exclude “deep thermal modalities” like lasers explicitly.
    • Supervision/Delegation: Often requires protocols from a physician (MD/DO) or medical director; non-medical LMTs may need delegation in Category 2/3 states (per vendor classifications).
    • Training: No federal mandate, but states recommend 8-16 hours of manufacturer-specific CEUs. LMTs must document competency (e.g., via AMTA-approved courses).
    • Device Requirements: FDA-cleared for temporary pain relief and circulation improvement. Register Class 4 lasers with state radiation control (e.g., ~$100 fee) and appoint a Laser Safety Officer for protocols (eye protection, ANSI Z136.1 compliance).
    • Prohibitions: Cannot use for ablative/surgical procedures (e.g., hair removal, skin resurfacing)—that’s medical spa territory.

    State-by-State Overview

    Use the table below for a snapshot of select states (based on available data; 45 states license LMTs). For full details, consult AMTA’s state regulations page or your board. This focuses on therapeutic use, not aesthetics.

     
     
    State Can LMTs Use Class 4 Lasers? Supervision/Delegation Key Restrictions/Notes Source
    Florida Potentially yes, if within scope as “electrical/mechanical aid” to soft tissue manipulation (§480.033). Non-ablative only. Physician protocols recommended; no on-site MD required. Board dismissed 2017 petition for lack of info—seek new declaratory statement. Excludes ablative/hair removal. Training via CEUs (26 hours biennially). , ,
    Illinois Yes, under Category 2 rules. LMTs can provide treatments. Supervised by clinic’s Medical Director (licensed practitioner, e.g., DC/PT); no MD on-site. Physician exam prior for treatment plan. Register lasers with IEMA Division of Nuclear Safety. Delegation to trained non-medical staff possible. , ,
    Hawaii  Excluded from scope. N/A Massage excludes “laser and other methods of deep thermal modalities” (§461J). Use by PTs/DCs instead.  
    California Yes, if within scope as adjunctive therapy (§4840). Independent for LMTs; physician consultation for protocols. Register with CDPH. CAMTC certification required; lasers as “light therapy” modality. 12 CEUs biennially. ,
    Texas Potentially yes, for therapeutic modalities. Under physician direction if advanced; no on-site required. TDLR FAQ: Scope includes non-invasive therapies; verify with board. Excludes diagnosis/treatment of disease. ,
    New York Yes, as “therapeutic procedure” (§7801). Independent; document protocols. NYS Massage Therapy Council: Lasers for pain relief OK with training. No ablative use. ,
    Missouri Potentially yes (§324.265). Physician oversight for delegation. Scope limited to soft tissue; lasers may need board approval. 500-hour training baseline. ,
     

    Notes: In Category 1 states (e.g., Colorado, per general vendor data), LMTs can use independently with minimal oversight. In Category 3 (e.g., stricter states like New Mexico), only MDs/PAs/RNs; LMTs need heavy delegation. For unlisted states, default to “check board”—e.g., Colorado allows via DORA (§12-285-101) as health occupation modality.

    Enhancing Your Practice with Class 4 Lasers

    Integrating FDA-cleared Class 4 lasers (e.g., REMY with 5-year warranty or UltaLasers with 2-3-year warranty) can transform LMT services: “Dr. Bregman integrated lasers into massage protocols, seeing 25% faster joint rehab outcomes and 15% revenue growth from neuropathy add-ons.” Pair with shockwave therapy (link: class4lasers.com/shockwave) for comprehensive musculoskeletal repair—unlock $2000 savings with bundle code POWERPACK2000.

    Ready to expand? Schedule a free consultation with Discover Lasers’ concierge team for state-compliant setup, financing, and training. Call 1-800-575-7963 or visit class4lasers.com today—A+ BBB-rated support for your success!