Adding a new service line to your private practice –– whether it’s Botox, IV hydration, mobile visits, remote psychiatry or fitness coaching — can feel like a natural next step for your business. Patients are asking, and the revenue potential looks promising.
Before you jump into even seemingly small additions to your private practice services, you’ll need to check how new procedures, new patient populations or even adding telehealth can redraw your risk profile in ways that matter to licensing boards and malpractice carriers.
Every few days at CM&F Group, an advanced practice provider (APP) reaches out after losing coverage with another carrier. It’s not uncommon for other carriers to deny coverage to clinicians launching a new small side hustle or when making changes to an existing practice. “We’ve seen NPs and PAs with plain-vanilla coverage for a family practice, for example, who form an S-Corp to launch IV hydration or aesthetics, and get non-renewed. The carrier says this isn’t the risk we want to cover,” says William Sullivan, Executive Vice President of CM&F Group.
What to Research Before Adding a New Medical Service Line to Your Practice
Before investing in training, marketing and capital equipment, consider first vetting the following with your medical malpractice insurance carrier and licensing board.
How New Services Affect Your Scope of Practice and Malpractice Coverage
If you’re considering adding aesthetics, launching IV hydration or offering laser treatments, don’t assume your existing policy or license contemplates those services.
“Adding a service often means entering a new scope of practice. Regulators and insurers treat these differently, so make sure your credentials and malpractice policy align before you turn on the marketing,” Sullivan says.
Simply put, aligning your license, training and coverage lets you scale safely.
Tip:
- Confirm your state board allows the specific service
- Document the training beyond a short seminar if the procedure has any risks
- Confirm in writing with your carrier that the new service is covered
Telehealth and Mobile Practice: How Practice Setting Impacts Malpractice Insurance
While telehealth and mobile clinics are everywhere now in the United States, not every malpractice insurance carrier has caught up. “Mobile work and even telehealth can be a sticking point for some of our competitors. Some companies don’t want in-home risk. Others require you to establish an in-person relationship before virtual care is covered,” says Sullivan.
Tip: If you’re shifting from brick-and-mortar to mobile or virtual-first, ask your carrier whether the practice setting itself changes underwriting.
Offering Dual Roles: How to Combine Clinical Care with Coaching Safely
Adding a cash-based service that complements your healthcare niche can be a great way to expand your business. For example, many physical therapists add strength and conditioning or small-group training, while some NPs and PAs add wellness or performance coaching.
For some carriers, this may be fine. Others only cover what they consider “pure healthcare” professions. “We can provide the same coverage for a physical therapist and a personal trainer by flipping ‘patient’ to ‘client.’ Not all carriers do that,” says Sullivan.
Tip: If you blend clinical care with non-clinical coaching, you need a policy and documentation that expressly covers both.
Practicing Across State Lines: What NPs and PAs Need to Know About Licensure and Liability
Some licensed clinicians try to “coach” across state lines where they aren’t licensed. That’s a legal and insurance gray area.
“You might be authorized to do something as a PA in one state, but when you cross into another, even virtually, the rules change,” says Sullivan. “Disclaimers like ‘this is not medical advice’ don’t fix a licensure problem.”
Tip: Compact initiatives are helping PAs and NPs practice across multiple states, but assume the answer is “no” before vetting the details for your discipline.
Confirm Malpractice Coverage Before Making Big Equipment Purchases
One of the biggest risks from a financial standpoint that clinician entrepreneurs make is making a massive equipment purchase and then finding out your license doesn’t allow you to use it. “We’ve seen people buy a $100,000 laser and then realize they can’t use it — or only a portion of its features — because of licensing or coverage limitations,” Sullivan says.
Tip: Verify your coverage and scope before making a big capital purchase.
Navigating Wellness Services Like Aesthetics, IV Hydration, and Longevity Treatments Safely
While wellness markets are in demand and thriving, regulation and insurance are still catching up. This lag reflects tension in the medical community around services that are more wellness than clinical, such as IV hydration, ketamine therapy and longevity infusions. “Even if your state permits a service, your policy might exclude it,” says Sullivan.
Tip: Check with your licensing agency and insurance carrier before offering wellness services.
Step-by-Step Playbook for Safely Expanding Your Healthcare Practice
After years of hearing cautionary tales, Sullivan offers guidance on safely expanding your services.
Scope & licensure
Verify the exact service is within your scope in every state where you practice.
Coverage & policy language
Contact your insurance carrier to request a rider, line-of-business or new policy that explicitly names your new line of service, such as Botox injections, laser resurfacing or IV hydration.
Practice medium
Disclose mobile and virtual care to confirm they’re approved. If your carrier requires in-person establishment of care before telehealth, find out how to properly document that workflow.
Capital investments
Determine your policy, scope and protocols before making any equipment purchases. When possible, negotiate escape clauses in leases contingent on final regulatory or certification approvals.
Ultimately, your insurance carrier should be a business partner helping you succeed, but that’s not always the case. “We should be helping clinicians capitalize on real opportunities, not creating new hurdles. You’ve got to bring your carrier along for the ride from day one,” says Sullivan.
Whether you’re expanding your practice or just need basic malpractice coverage, click here to learn more about professional liability coverage for advanced practice providers.
Frequently Asked Questions
- Do I need to update my malpractice insurance when adding a new service line? Yes. Anytime you add a new procedure or service—like Botox, IV hydration, or telehealth—you should confirm that your malpractice insurance policy covers it. New services can shift your risk profile and may require an updated rider or policy adjustment to ensure continuous protection.
- Can I offer new services if they fall outside my current scope of practice? No. Expanding beyond your licensed scope of practice can lead to regulatory and insurance issues. Before marketing or launching any new service, verify that your state licensing board allows it and that you’ve completed the necessary training to perform it safely and legally.
- What should I check before investing in new equipment or launching wellness services? Before purchasing capital equipment or launching wellness-based offerings such as aesthetics or longevity infusions, confirm that your state license and malpractice coverage explicitly allow those services. Buying equipment before verifying coverage could lead to major financial losses if the service isn’t approved.
