Sales tax in Nevada for med spas
Nevada taxes retail sales of tangible personal property. The Department of Taxation’s FAQ says a service is taxable only when it is necessary to complete the sale of goods, so neuromodulator, filler, laser, microneedling and facial treatments are not taxed. Retail skincare, sunscreen and devices are. Prescription medications are exempt, so your neuromodulator order is; the practice is the consumer of gloves, needles, numbing cream and equipment and pays tax at purchase or use tax on out-of-state orders.
The statewide base is 6.85% — 2% state, 2.6% Local School Support Tax and 2.25% of county relief taxes — and counties add their own option taxes: 8.375% in Clark County (Las Vegas, Henderson, Summerlin) since January 1, 2020, and 8.265% in Washoe (Reno, Sparks) since April 1, 2017. Register through My Nevada Tax after you have an EIN and a state business license; the permit is $15 per location. Returns are due the 20th — monthly if taxable sales exceed $10,000 a month, quarterly below that, annually if the prior year was under $1,500 — and from December 7, 2026 every filing must be electronic.
In Summerlin: a $700 filler treatment, a $150 serum and a $45 sunscreen on one ticket. Only the $195 of retail is taxed: $195 × 8.375% = $16.33; ticket total $911.33. The same ticket in Reno carries $16.12. Packages that bundle a treatment with a take-home product need the retail piece separately stated; our med spa sales tax guide walks through it.
Who can own a med spa in Nevada (CPOM and supervision, summarized)
This is a summary, not legal advice. Nevada has no med spa statute — the ASDSA says Nevada “does not have any state laws regulating medical spas” — and the boards regulate through their licensees. NRS 89.050 limits a professional entity rendering medicine to persons licensed in medicine, osteopathy, homeopathy, chiropractic, naprapathy or psychology, and the Board of Medical Examiners polices the corporate practice of medicine through its unprofessional-conduct rules, so a non-physician owner usually holds a management company that contracts with a physician-owned professional entity — see our MSO and professional-entity guide.
Who injects is in statute. NRS 629.086 allows dermal fillers only by a physician or PA, an RN or APRN, or a dentist or podiatrist with board-prescribed training, within scope, in a medical facility or practitioner’s office, with no delegation to anyone else; a violation is a misdemeanor, and NRS 630.306 makes unauthorized injection of fillers or botulinum toxin grounds for discipline. The Board of Nursing’s January 2025 practice decision puts RN cosmetic injectables under direct supervision after a practitioner’s assessment and order, and outside LPN scope. Advanced estheticians (SB 291 of 2021, adjusted by SB 249 of 2023) perform non-ablative device work under a supervising physician, PA or APRN; basic estheticians may not inject or run medical lasers.
The Board of Medical Examiners’ draft for the 2027 session would enact a Medical Spa Safety Act with an online registry, a $500 annual fee and a January 1, 2028 start; nothing is law yet. Confirm all of it with a health-care attorney licensed in Nevada.
State business taxes for a Nevada med spa entity
Nevada has no personal income tax, no corporate income tax and no franchise tax on income, so LLC and S corporation profit reaches the owner untaxed by the state and the S corporation decision is purely federal. Two taxes take their place. The Modified Business Tax is a payroll tax: every employer subject to Nevada unemployment law pays 1.17% of quarterly gross wages above $50,000, after subtracting employer-paid health benefits, on a return due even when the tax is zero.
The Commerce Tax applies once Nevada gross revenue in the July-to-June fiscal year exceeds $4,000,000. Below that there is no filing. Above it, the tax is a small percentage of revenue over the $4 million deduction, set by NAICS code — 0.190% for health care and social assistance, 0.142% for other services, 0.111% for retail — on a return due 45 days after June 30 (August 14, 2026 for the year just closed). Half of the Commerce Tax paid comes back as a credit against the Modified Business Tax in the following four quarters, so a group crossing $4 million should model both together.
The Secretary of State takes its share annually: a $200 state business license and $150 annual list for an LLC, $500 and at least $150 for a corporation, due the last day of the anniversary month. Our LLC vs. S corporation guide covers the federal election when the state is silent.
Payroll in Nevada for injectors and front desk
Nevada has no state income tax withholding, so a Nevada paycheck carries only federal withholding and FICA on the employee side. The employer side is where the state shows up. Unemployment insurance runs through the Employment Security Division of DETR: you must register once you pay $225 of wages in a calendar quarter, then file the Employer’s Quarterly Contribution and Wage Report by April 30, July 31, October 31 and January 31. For 2026 the taxable wage base is $43,700, rising to $45,400 in 2027, and a new employer pays 2.95% plus the 0.05% Career Enhancement Program assessment for 14 to 17 quarters before experience rating moves the rate inside the 0.25% to 5.40% schedule. A full-time injector therefore costs $1,311 of Nevada unemployment tax a year.
The Modified Business Tax rides on the same wages: a practice with $140,000 of quarterly payroll and $10,000 of employer-paid health premiums owes 1.17% × ($130,000 − $50,000) = $936 for the quarter. Nevada has no state paid family leave or disability payroll program and no city payroll taxes. Injectors are W-2 under the IRS common-law test — the practice sets the schedule, the protocols and the price list — and commission plans need the base-plus-commission math in our injector pay guide, because the Modified Business Tax and unemployment tax both follow gross wages including commissions.
Registrations, filings and deadlines checklist for a Nevada med spa
Fees checked November 2026; licensing rows summarize, not advise.
| Item | Where | Fee / due date | Source |
|---|---|---|---|
| Form the entities | Nevada Secretary of State via SilverFlume | LLC: $75 articles, $150 initial list, $200 state business license ($425 total); corporation: $150 initial list, $500 license | SOS fee schedule; NRS 76.100, 78.150 |
| Annual list and license renewal, each entity | SilverFlume | LLC $150 list plus $200 license; last day of the anniversary month; $75 late fee on the list | SOS |
| Sales and use tax permit | My Nevada Tax (TAX-F006) | $15 per location; returns due the 20th; electronic filing required from Dec. 7, 2026 | Department of Taxation |
| Modified Business Tax | My Nevada Tax | Quarterly; 1.17% of wages above $50,000 per quarter; file even at zero | Department of Taxation |
| Commerce Tax | My Nevada Tax | Only above $4,000,000 of Nevada gross revenue; due 45 days after June 30 | Department of Taxation |
| Unemployment insurance | DETR Employer Self Service | At $225 of quarterly wages; 2.95% plus 0.05% CEP on first $43,700 (2026) | DETR ESD |
| Workers’ compensation | Private carrier | Required of Nevada employers; confirm with your carrier | DIR |
| Clinical | Board of Medical Examiners, Board of Nursing, Board of Cosmetology | No med spa facility license today; filler injectors per NRS 629.086; advanced esthetician license for device work; 2027 registry proposed | NRS 629.086; BME 2027 proposals |
Federal items are in our opening checklist.
How we work with Nevada med spas from Tampa
Onboarding is remote: a 20-minute fit call, then read-only access to your bank, processor and POS. We pull exports from Boulevard, Zenoti, Aesthetic Record, Vagaro, Mindbody, Nextech or PatientNow into QuickBooks Online, split revenue by service line and retail, and close the books by the tenth business day. Nevada is three hours behind Tampa, so we hold afternoon hours for Las Vegas and Reno calls; your 2 p.m. is our 5 p.m.
We file the sales tax returns, the quarterly Modified Business Tax, the Commerce Tax return when you cross $4 million, the DETR wage reports, the annual list and license renewals, and the federal returns for every entity. You keep the local pieces: your Nevada health-care attorney, board filings, workers’ comp, and signing what we prepare. Med Spa Core starts at $1,500 a month, month-to-month after onboarding; see pricing, the med spa service page or request a fit call.
A Nevada example
Illustrative only: a single-location Summerlin practice, a physician-owned professional LLC taxed as an S corporation, with $1,800,000 of revenue, eight employees paid $560,000 a year and $40,000 of employer-paid health premiums.
- Sales tax. $200,000 of retail × 8.375% = $16,750 collected for the year. Tax on $1,600,000 of treatments: $0.
- Income tax. Nevada: $0, on the entity and on the owner. The federal return still decides the S corporation salary question.
- Modified Business Tax. Quarterly wages of $140,000 less $10,000 of health premiums less the $50,000 exemption = $80,000 × 1.17% = $936 a quarter, $3,744 a year.
- Commerce Tax. Revenue is under $4,000,000, so no tax and no return.
- Unemployment tax. The first injector, paid $85,000, costs 3.0% × $43,700 = $1,311 plus $42 of federal FUTA. All eight employees above the wage base: $10,488.
- Secretary of State. $200 state business license plus $150 annual list, $350 a year.