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October 30, 2026

Who Can Perform a Good Faith Exam? RN, NP, PA, and MD Rules by State

TABLE OF CONTENT

Need a Good Faith Exam?

Talk to our team about on-demand or scheduled exams. Exams start at $27.

Many med spa owners ask the same thing before they hire or book help: who can perform a good faith exam, and who cannot? The short version is that rules vary by state. This guide explains the roles involved, what to confirm in each state we serve, and how a telehealth platform fits in.

Who Can Perform a Good Faith Exam?

A good faith exam is generally performed by a licensed healthcare professional whose scope of practice allows them to evaluate a patient and make a treatment decision. Depending on the state, this can include physicians, nurse practitioners, and physician assistants. Whether registered nurses may do it, and under what supervision, differs widely. Always confirm with your state board and healthcare attorney.

Can a Nurse Do a Good Faith Exam?

It depends on the nurse’s role and the state. A registered nurse (RN) generally does not make independent medical diagnoses or treatment decisions, so many states do not allow an RN to clear a patient on their own. Where state law permits, an RN may gather history or support an evaluation under a physician’s or advanced practice provider’s direction.

A nurse practitioner (NP) has a broader scope. In some states, an NP can evaluate patients independently. In others, an NP needs a collaborating or supervising physician. That difference changes who can sign off on a GFE at your practice.

Can a Physician Assistant Perform a Good Faith Exam?

Physician assistants (PAs) usually work under a supervising or collaborating physician. In many states, a PA can evaluate patients under that agreement, but supervision, chart review, and delegation details vary. If a PA at your practice performs GFEs, check what your state expects in writing.

Can a Physician Perform a Good Faith Exam?

A licensed physician (MD or DO) can generally perform the evaluation, since it falls within the physician’s scope. The practical question is whether the physician is licensed in the patient’s state and whether the state allows the evaluation through a method like telehealth. A physician who is licensed in one state cannot assume that license applies in another.

What Are the GFE Provider Requirements?

GFE provider requirements usually come down to a few checks. They apply whether the evaluation happens in person or by telehealth.

Active license. The professional holds a current license in the state where the patient is located.
Scope of practice. The role allows the professional to perform the evaluation and make the clearance decision.
Supervision or collaboration. If the role requires it, the right arrangement is in place and documented.
Documentation. The evaluation is recorded in a way your state and your medical director expect.
Informed consent. The patient understands the process, and any recording follows consent and privacy rules.

How Do GFE Rules Differ by State?

The table below is a starting point for conversations with your attorney, not a legal summary. It lists the states MHC serves and what a practice generally needs to confirm in each.

State	Roles commonly involved	What to confirm for your practice
California	Physicians, NPs, PAs	Supervision rules, corporate practice limits, and who may perform the exam
Texas	Physicians, NPs, PAs	Delegation and supervision requirements and telehealth rules
Florida	Physicians, NPs, PAs	Supervision or protocol requirements and telehealth rules
New York	Physicians, NPs, PAs	Scope of practice for each role and telehealth rules
Arizona	Physicians, NPs, PAs	Supervision or collaboration requirements and telehealth rules
Nevada	Physicians, NPs, PAs	Scope of practice and supervision rules for aesthetic services
Illinois	Physicians, NPs, PAs	Collaboration agreements and telehealth rules
Georgia	Physicians, NPs, PAs	Delegation and supervision requirements
Colorado	Physicians, NPs, PAs	Scope of practice and supervision requirements

Rules change, and each state has its own wording. Treat every entry as a prompt to ask the right question, and never as proof that an arrangement is allowed.

Does the Provider Have to Be in the Same State as the Patient?

In most cases, the licensed professional needs to be authorized to practice where the patient is located. For telehealth, the patient’s location generally decides which state’s rules apply. That is why a platform that coordinates evaluations by state matters. Ask any GFE provider how they match professionals to patients.

Can Telehealth do the Exam?

Often yes, though rules vary. Our post on whether a good faith exam can be done by telehealth covers this in depth.

Who Makes the Final Decision?

The licensed professional does, independently. MHC coordinates the evaluation and supplies documentation, but it does not make clinical decisions and does not give legal advice. Your practice stays responsible for its own compliance.

How Does MHC Coordinate Good Faith Exams?

MHC provides a HIPAA-compliant, browser-based platform. Your team enters the patient’s information, chooses an on-demand or scheduled exam, and a licensed professional completes the evaluation. Clearance can often come back within minutes, and exams start at $27. Where consent and privacy rules allow, a video-recorded exam is available. You can see exam services by location on our services page.

Common Mistakes Med Spas Make

Some problems come up again and again. A practice assumes that any nurse can clear a patient. A provider is licensed in one state but evaluates a patient in another. A supervision arrangement exists on paper but is never reviewed. Or the exam happens, but nothing is recorded in the chart. Each of these is easy to prevent with a written protocol, a quick license check, and a habit of filing every evaluation. Review your process with your medical director and healthcare attorney at least once a year, and again whenever a state changes its rules.

What Should I Ask Before Choosing a Provider?

Which licensed professionals will evaluate my patients, and in which states are they licensed?
How do you match professionals to the patient's state?
What documentation will I receive, and how long is it stored?
Is the platform HIPAA compliant?
How do you handle video recording and consent?
Who is responsible for compliance decisions?

If an answer is vague, keep asking.

Frequently Asked Questions

Can an esthetician perform a good faith exam?

No. Estheticians are not licensed to diagnose or make medical clearance decisions. They can perform certain services within their scope, but a licensed healthcare professional must do the evaluation.

Can my medical director do all my exams?

A medical director can, if they are licensed in the right state and the exam method is allowed. Many practices use telehealth support because one person cannot always keep up with demand.

Does an NP need a physician to perform a GFE?

It depends on the state. Some states let NPs evaluate patients independently. Others require collaboration or supervision.

Is a telehealth GFE as valid as an in-person one?

In many states, yes, as long as the professional is licensed there and the state allows telehealth. Confirm with your attorney.

Get Clear on Your Own State

The right answer to who can perform a good-faith exam depends on your state’s laws and your medical director’s protocols. If you want help setting up a consistent process, see how MHC works or call 877-811-4331. We are open Monday to Saturday, 7:00 AM to 6:00 PM, and Sunday, 9:00 AM to 5:00 PM.

Ready for Your Next Good Faith Exam?

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Medical Health Covers Inc. operates solely as an independent technology platform that facilitates connections between clinics and licensed healthcare providers who perform Good Faith Examinations (“GFEs”). Read More

Telehealth services facilitated through clinics using this platform are provided by licensed healthcare professionals in accordance with applicable state laws who exercise their own independent clinical judgment to determine whether a patient may safely proceed with a requested treatment or service based on the information provided. Availability of services may vary by state, and patients must be physically located in a state where the evaluating provider is licensed at the time of the examination. Medical Health Covers Inc. is not a medical provider and does not practice medicine or provide healthcare services. The company does not diagnose medical conditions, provide medical advice, or determine treatment plans. Medical Health Covers Inc. does not manufacture, sell, market, promote, prescribe, dispense, or fulfill medications, treatments, or medical devices, and does not participate in the commercial sale, marketing, fulfillment, or payment processing of medical treatments or prescriptions. All medical decisions — including whether to provide treatment, prescribe medication, or issue medical clearance — are made solely by the evaluating licensed healthcare provider, the clinic’s designated medical director, or the dispensing pharmacy, where applicable. A Good Faith Examination or medical clearance does not guarantee that any treatment, procedure, or prescription will be provided. Clinics, pharmacies, and licensed healthcare providers remain fully responsible for their own clinical decisions, regulatory compliance, and patient care. The content on this website is provided for informational purposes only and does not constitute medical advice. Patients should consult directly with a licensed healthcare professional regarding any medical condition or treatment.