Quick take: Texas did not ban Complementary & Alternative Medicine (CAM). The Board simplified and moved the rules, and now requires a specific, standardized disclosure & consent form—signed by the physician and the patient—before any CAM therapy is provided. The Board’s September 2025 Bulletin confirms the intent: reduce redundancy, increase transparency, and make compliance easier—not restrict access. Texas Municipal Bureau
Legal note: This article is general information for licensed professionals and is not legal advice. Consult your health‑care attorney for your specific model.
At‑a‑glance: What changed?
- Rules reorganized: CAM standards moved from old Chapter 200 to new Chapter 171, effective Jan 9, 2025. Texas Secretary of State+1
- Definitions updated and retained in §171.1 (e.g., alternative vs. complementary vs. conventional). Legal Information Institute
- Consent now standardized: Before any CAM drug, device, treatment, or intervention, the physician and patient must review and execute the Board’s CAM Treatment Disclosure & Consent Form; the fully executed form is part of the record. The form may not be altered (other than translation or extra pages for supplemental information). Legal Information Institute
- Board clarification (Sept 2025): Deleting phrases like “reasonable latitude” and “patients have a right to seek CAM” did not reduce availability. The new form is to improve transparency and compliance. Texas Municipal Bureau
1) What counts as CAM under the new Chapter 171?
Alternative medicine = methods of diagnosis, treatment, or interventions not generally considered conventional; they may or may not be FDA‑regulated and may be offered if potential therapeutic gain is not unreasonably outweighed by risk.
Complementary medicine = combining conventional medicine with some form of alternative medicine. Legal Information Institute
Examples that often trigger CAM analysis (illustrative, not exhaustive):
- IV “vitamin” infusions or novel wellness infusions marketed for performance, anti‑aging, detox, etc.
- Peptides and compounded biologics marketed for wellness or longevity.
- Ozone, chelation, hyperbaric oxygen used outside conventional indications.
- Regenerative claims around PRP/exosomes (particularly where FDA status is uncertain or promotional claims extend beyond conventional care).
Tip: If a reasonable peer group would say “this isn’t standard conventional care for this diagnosis,” treat it as CAM and use the standardized CAM consent. When in doubt, err on the side of using the form. The rule’s definitions and the form itself expect you to surface FDA/DSHEA status, mechanism, risks, alternatives, and follow‑up. Legal Information Institute+2Texas Secretary of State+2
2) The Required CAM Consent—What it is and where to get it
Rule §171.2 requires the physician and patient to review and execute the Board’s CAM Treatment Disclosure & Consent before you provide any CAM therapy; the completed form must be in the chart. You cannot change the Board’s form other than translation or adding extra pages for supplemental information relevant to the patient/course of care. Legal Information Institute
You can download the official three‑page Complementary & Alternative Medicine Treatment Disclosure and Consent (labeled “Figure: 22 TAC §171.2(b)”) from the Texas Register archive. It includes: condition(s), treatment(s), assessment, detailed disclosures (objectives, risks/benefits, interference with other care, mechanism, FDA/DSHEA/compounding status, individualized plan, risk/benefit analysis vs options, expected outcomes, and periodic review). Texas Secretary of State+2Texas Secretary of State+2
Why this exists: The Board explains the standardized consent is meant to simplify compliance and improve clarity for patients; CAM remains authorized and available in Texas. Texas Municipal Bureau
3) Who must sign—and can an NP/PA do it?
The rule is explicit: “the physician and patient must review and execute” the form. The form itself contains a physician signature line at the top. Even when an APRN/PA provides care under delegation, ensure the supervising physician signs this CAM disclosure and consent. Legal Information Institute+1
Related obligations: §171.2 also reiterates that physicians must comply with all statutes and rules, including adequate medical recordkeeping. Legal Information Institute
4) Step‑by‑step: How to comply without slowing your workflow
Before offering any CAM therapy:
- Classify the service (Is it clearly conventional? If not, treat as CAM.) Document your rationale. Legal Information Institute
- Confirm physician involvement for CAM consent in your scheduling/clinical workflow. Tie a task to the encounter. Legal Information Institute
- Review the Board’s form with the patient. The physician and patient must go line‑by‑line, initialing each required statement; use “N/A” where allowed. Texas Secretary of State
- Disclose FDA/DSHEA/compounding status of any drug/supplement/remedy used. (The form has specific checkboxes.) Texas Secretary of State
- Explain the mechanism and the expected outcomes in patient‑friendly language; include risks, alternatives, and when you will re‑evaluate efficacy and safety. Texas Secretary of State+1
- Tailor the treatment plan to the individual with a documented medical history, exam, prior conventional treatments/outcomes, and any necessary referrals. Texas Secretary of State
- Execute signatures (physician + patient) before the first CAM treatment. File the form in the chart (paper or EHR). Legal Information Institute
- Add supplemental pages if needed (e.g., protocol details, monitoring plan, interval reassessment schedule)—but don’t alter the Board’s form language. Legal Information Institute
- Track periodic review at reasonable intervals (progress, new etiology info, whether objectives are met). Set ticklers in your EHR. Texas Secretary of State
- Audit yourself quarterly: randomly pull 5 CAM charts to ensure the form and all required elements are present.
5) Documentation: The specific elements the Board expects to see
Rule §171.2(b) allows you to keep this information in the Board’s form or in another format that contains at least the same information. In practice, use the form—then mirror those fields in your EHR templates so your progress notes remain consistent. Required elements include: diagnosis/indication(s), treatment(s), assessment (history, exam, prior conventional care), disclosures (objectives, risks/benefits, interference with other care, mechanism), regulatory status (FDA/DSHEA/compounding) for each agent, individualized plan, risk/benefit vs alternatives (including no treatment), reasonable expectation of benefit, and periodic review. Legal Information Institute+2Texas Secretary of State+2
Pro tip: The form also reminds physicians to document whether off‑label use or CAM is administered. Off‑label alone does not automatically make a therapy “CAM,” but you must document it clearly either way. Build an “Off‑label/CAM” toggle into your note template to force the choice. Texas Secretary of State
6) How this intersects with other Texas requirements
- Reorganization context. The CAM rules were adopted in Chapter 171 and the prior Chapter 200 structure was repealed/streamlined in 2024–2025 rulemaking. Texas Secretary of State
- CAM consent is additive. If your CAM service also includes a procedure that appears on the Texas Medical Disclosure Panel (TMDP) lists, you may still need to use the TMDP‑mandated procedural consent(s) in addition to the CAM consent. Texas Health and Human Services
- General Board rules still apply. Supervision/delegation, advertising, medical records, and standards of care continue to govern your practice. §171.2(b) explicitly references maintaining adequate medical records. Legal Information Institute
7) Ketamine & other “watch‑list” therapies
The Board flagged ongoing work toward psychotropic ketamine therapy standards (e.g., dosing, continuous monitoring, immediate physician availability, role of APPs). These are under evaluation—be alert for future rules that may add requirements beyond Chapter 171. Texas Municipal Bureau
8) Implementation checklist (copy/paste into your SOP)
Governance & Training
- ☐ Identify a CAM lead physician and designate back‑ups.
- ☐ Train all providers and front desk on when CAM consent is required and how to route patients to the physician for the consent step.
- ☐ Add CAM consent to your new‑service intake packets and appointment types.
EHR & Forms
- ☐ Upload the Board’s CAM consent and make it required for flagged services.
- ☐ Build EHR templates mirroring the form’s assessment/disclosure fields.
- ☐ Add an “Off‑label vs CAM” documentation toggle.
- ☐ Create tasks/ticklers for periodic review (e.g., at 4–12 weeks).
Clinical Safety
- ☐ For each CAM protocol, maintain mechanism summaries, FDA/DSHEA/compounding status, inclusion/exclusion criteria, and interactions with conventional care.
- ☐ Standardize emergency/transfer criteria and communicate them to staff.
Quality & Audit
- ☐ Monthly dashboard: number of CAM encounters, % with complete CAM consent on file.
- ☐ Quarterly chart audit (random 5–10 charts) against §171.2(b) elements.
9) Common scenarios & how to handle them
Q: We offer IV “wellness” infusions to healthy clients—do we need CAM consent?
If a therapy is not generally considered conventional for a recognized diagnosis (e.g., performance/anti‑aging detox infusions for well people), treat it as CAM. Use the Board’s form before therapy and document FDA/DSHEA status of each component. Legal Information Institute+1
Q: Can my NP/PA review and sign the CAM consent instead of the physician?
No. The rule requires the physician and patient to review and execute the Board’s form; the form includes physician signature. Legal Information Institute+1
Q: Can we customize the form with our own language?
You may translate or add pages for supplemental information—but you may not modify the Board’s form text or structure. Legal Information Institute
Q: If a therapy is conventional but used off‑label, do we still need the CAM consent?
Off‑label use must be documented; off‑label alone does not automatically make care “CAM.” Apply the definition: if the therapy is not generally considered conventional for this condition, use the CAM form; otherwise, ensure robust off‑label consent within your standard process. Legal Information Institute+1
Q: Where do we get the official CAM consent form?
From the Texas Register (Figure: 22 TAC §171.2(b)) and through the Board’s rules pages. It’s a three‑page standardized document. Texas Secretary of State
10) What the Board said—verbatim intent (and why it matters to you)
In the September 2025 Bulletin, the Board explained it removed redundant language already addressed in statute; the presence of CAM rules themselves confirms legitimacy and availability. The new disclosure form is about clarity and compliance, not restriction. Build your processes accordingly and you’ll reduce risk while preserving access for patients who seek CAM options. Texas Municipal Bureau
