Best Med Spa Management Companies and MSOs (2026): 5 Compared

For med spa owners. Updated October 2, 2026 · Prepared by Prospyr. Prospyr makes practice software, not management services, and none of the companies below is a Prospyr product. Each summary reflects what the company publishes on its own website, checked October 2026. Deal terms, fees and ownership rules change, so get every term in writing and have your own healthcare attorney review it before you sign.

What does a med spa management company (MSO) do?

A med spa management company, often set up as a management services organization (MSO), runs the business side of a practice so the medical side can stay with licensed providers. That usually means hiring and HR, payroll and bookkeeping, vendor contracts and group purchasing, marketing, reporting, and sometimes access to capital. In states with corporate practice of medicine rules, an MSO is also the entity a non-physician owner can hold while a physician-owned practice handles patient care. The differences that matter are how the company gets paid, whether it takes equity, and how hard it is to leave.

The 5 management companies at a glance

How we chose this list

We looked for companies that name med spas or aesthetic practices as a core market and offer to manage or support the business side, then checked four things an owner can verify before a first call:

1. How the company is paid: a flat fee, a share of revenue, a share of growth, or equity.
2. What you keep: equity, brand, and control over clinical and vendor decisions.
3. What it actually runs: daily operations, back office only, or compliance and medical direction.
4. How plainly it explains its terms on its own website.

We left out practice-software companies that also sell MSO setup, because they compete with Prospyr, and private equity buyers whose main offer is to purchase your practice (we cover those in our guide to private equity platforms in med spas). The order is our editorial view, not a measure of results. This is a young and thin category, so treat it as a starting shortlist.

1. Aviva Aesthetics

Aviva Aesthetics is a Chicago-based med spa platform that describes itself as building a private-equity-quality company that is "owned, led, and governed by med spa business owners." Its site states that it is a DuneGlass Capital company and that its team has decades of experience building healthcare management services organizations.

What stands out:

• Entrepreneur Equity model. Aviva states that owners keep 100% of the equity in their business, and all profits, while it helps prepare the group for a collective future sale to private equity.
• Owner-led governance. It reports a med spa owner-majority board and owners chairing all of the platform's management committees.
• Pick-what-you-need services. Finance and accounting (monthly statements, bookkeeping, payables, payroll tools, KPI tracking), marketing and growth, pre-negotiated vendor rates for toxins, fillers and equipment, and HR and benefits support.
• Growing footprint. Its 2026 news lists new partner practices in Texas, Arizona, Illinois, Ohio, Georgia, New Mexico and Oregon.

Aviva advertises that owners can earn 2 to 3 times more at a platform sale than in a traditional private equity deal. That is a projection, not a guarantee.

Right for: an established, profitable med spa owner who wants back-office support now and a group exit later, without selling a majority stake today. Ask: what you give up when the platform is sold, what the fees are before then, and how you leave if you change your mind.

2. Upkeep Ventures

Upkeep Ventures offers to take over day-to-day operations of an existing med spa while the owner keeps the business. It is led by Shane Smith, who the site says founded UPKEEP Med Spa (locations in New York and Texas) and is CEO of Alchemy 43; it reports 16+ locations under management across those two brands.

What stands out:

• No equity, no flat fee. Upkeep states that it takes 0% equity and charges no flat fees or retainers; its pay is tied to incremental growth above your existing baseline.
• Broad scope. Operations management (staffing, HR, vendor contracts, compliance and licensing support, inventory), capital access, group purchasing including injectables, marketing, monthly P&L and KPI reporting, and a 30/60/90-day transition plan.
• Brand stays yours. It states it does not rebrand partner practices.

Right for: an owner who is burned out on operations and wants to step back without selling. Ask: exactly how the baseline is set and the growth share is calculated, how long the agreement runs, how many outside practices it manages today beyond its own two brands, and who makes hiring decisions for your providers.

3. myMedSpa

myMedSpa partners with growth-stage med spa owners to handle operations, staff development, systems and group purchasing. Founded by CEO Jerred Mann, it describes its team as former med spa owners, providers and healthcare professionals, and lists practice owners from Rejuvv Luxury Spa and Serenity Medical Spa on its team page. It says it is "smaller by design" and selective about partners, and that each deal is custom.

The site reports that Rejuvv grew from 2 to 5 locations in six months after partnering. myMedSpa's wording ("we don't just invest") suggests some partnerships include investment, but it does not publish deal structure or fees.

Right for: a multi-location or growth-stage owner who wants an operator team working inside the practice, not remote consulting. Ask: whether the deal includes equity, how the management fee is set, and what happens to your brand and staff if you part ways.

4. MedGrid MSO

MedGrid MSO combines physician medical direction, compliance documents and a wholesale supply catalog in one membership for med spas, IV, weight-loss and other wellness clinics. It is built by Skydell Holdings, a medical supply company. MedGrid states it connects clinics with a physician licensed in their state, uses friendly-PC structures to stay within corporate practice of medicine rules, keeps delegation agreements, standing orders and consents current, and advertises going from signing to seeing patients in about 30 days. It also lists accounting and payroll "split correctly by entity" and marketing services.

Its pricing page says onboarding and the monthly fee are quoted per clinic, with a 12-month term; catalog access is free for verified clinicians.

Right for: a nurse practitioner, injector or entrepreneur opening a first clinic who needs the structure and the compliance file more than an operator. Ask: who drafts and owns the MSO and PC agreements, what the fee covers, and whether you can buy supplies elsewhere (its site says you can).

5. Staffingly

Staffingly is not an MSO. It is a healthcare back-office outsourcing company whose med spa service provides HIPAA-trained, offshore staff in India, Pakistan and Bangladesh to handle intake, scheduling, before-and-after photo handling, membership billing follow-up, GLP-1 program admin and lab coordination inside the software you already use. It states that it signs a BAA, works on administrative tasks only, and can go live in one to two weeks. It advertises a solo compliance bundle at "well under $500 a month."

Right for: an owner who wants to keep full control of the business but needs admin hours covered. Ask: who supervises the team day to day, how access to patient records is controlled, and what notice is needed to cancel. Staffingly also sells AI tools; we list it for its staffing service only.

Questions to ask any med spa management company

1. How are you paid? Get the formula in writing: flat fee, percentage of revenue, share of growth, or equity. In an MSO-PC setup, ask your attorney whether the fee is set at fair market value.
2. What do I keep? Equity, brand name, patient list, vendor accounts, and the right to choose your own providers and suppliers.
3. How do I leave? Ask for the term, the notice period, any buyout or unwind cost, and what happens to staff, contracts and records on exit.
4. Who makes clinical decisions? Management companies should run business functions only. Confirm the medical director or physician-owned practice keeps every clinical call.
5. Will you sign a BAA? Any company touching patient records, intake or billing should.
6. Who drafts the legal documents? Have your own healthcare attorney review the management services agreement, even if the company provides one.
7. Can I talk to current partners? Ask for two owners who joined at least a year ago.

Where Prospyr fits

A management company runs the business side; your practice platform is where the day-to-day records live. If an MSO will handle reporting, staffing or purchasing across locations, make sure it can read the data it needs, such as bookings, revenue by provider and product use, from one system. Prospyr's analytics and multi-location tools are built for that, or you can book a practice demo.

Frequently asked questions

Do I need an MSO to own a med spa?

It depends on your state and your license. In states with corporate practice of medicine rules, non-physicians usually own the business through an MSO while a physician owns the medical practice. Our PC, PLLC and MSO comparison explains the structures, and a healthcare attorney should confirm what your state allows.

How much does a med spa management company cost?

Most companies on this list do not publish fees. Upkeep Ventures states it is paid only on growth above your baseline, MedGrid quotes per clinic on a 12-month term, and Staffingly advertises a solo bundle under $500 a month. Ask every company for a written fee formula.

Is an MSO the same as selling to private equity?

No. An MSO can be a structure you own yourself or a service you hire. A private equity platform usually buys a majority of your practice. Some models on this list, like Aviva, sit in between. See our private equity platforms guide for buyers.

What should a management company never control?

Clinical decisions. Treatment protocols, delegation, prescribing and patient care belong to licensed providers and the medical director. If you also need a medical director, compare options in our medical director services list.

When does a growing practice need a management partner?

Often when an owner is running two or more locations and spending most of the week on staffing, vendors and reporting. Before you sign, benchmark your numbers with these KPI resources and consider a multi-location consultant as a lighter option.

Want your company considered?

We review this list quarterly. Companies that manage or support med spa operations can send their website and what they offer practices to info@prospyrmed.com. Inclusion is editorial and not paid.

Editorial scope

This list is based on each company's public website, checked October 2026 with AI-assisted research. Companies did not review this article before publication. It is not legal advice, a guarantee of results, or a substitute for checking references and having an attorney review your agreements. Read our methodology or report a correction.