Texas Ketamine Clinic Setup Attorneys

We Help Physicians and Investors Structure Compliant Ketamine Clinics – and Prepare for Proposed 2026 TMB Rules

Ketamine has been used as an anesthetic in medical settings for decades but, in recent years, there has been increasing interest in the use of low-dose ketamine as a treatment for PTSD, depression, and anxiety. This interest has led to increased demand for ketamine clinics – specialized medical facilities that offer ketamine infusions as a treatment option for these conditions.

We help physicians and healthcare investors structure ketamine therapy clinics in compliance with state and federal regulations, including licensing and supervision requirements, in preparation for offering ketamine for the treatment of depression and other mental health issues.

Contact Hendershot Cowart P.C. today at (713) 783-3110 to start your ketamine practice the right way or bring an existing practice into compliance.

On This Page

• New in 2026: Texas Medical Board Proposes Major Ketamine Therapy Rules
• Who Can Own a Ketamine Clinic?
• Who Can Administer Ketamine?
• Is Ketamine an FDA-Approved Treatment for Depression?
• Which Licenses Do You Need to Open a Ketamine Clinic?
• What Is the Best Structure & Entity Selection for a Ketamine Clinic?
• Can Ketamine Be Administered via a Mobile Clinic?
• Do I Need a Lawyer to Open a Ketamine Clinic in Texas?
• How Our Attorneys Can Help

New in 2026: Texas Medical Board Proposes Major Ketamine Therapy Rules

The Texas Medical Board is in the process of adopting new rules that would fundamentally change how ketamine therapy clinics operate in Texas. Physicians, clinic owners, and investors considering entering this space should be aware that the regulatory landscape is actively shifting.

The proposed rules – published in the Texas Register and currently under public comment review – would establish, for the first time:

• Mandatory TMB registration for all psychotropic ketamine therapy (PKT) practices not otherwise exempt
• Medical Director requirements, including strict physician eligibility standards and oversight duties
• Patient monitoring standards, including specific monitoring ratios, documentation intervals, and post-treatment observation requirements
• Equipment and medication mandates that many current ketamine operators do not meet today
• Adverse event reporting obligations, including 24-hour reporting to the Board for certain events

These rules have been published and revised three times since January 2026, most recently in the July 10, 2026 Texas Register. The earliest possible adoption date is August 9, 2026. If adopted, most requirements would take effect 180 days after adoption – though adverse event reporting obligations would apply immediately.

The rules are not yet final. The TMB is still accepting public comments, and a public hearing will be scheduled before any vote on adoption. We are actively monitoring the rulemaking process for updates.

For a detailed summary of the proposed rules and what they would mean for your practice, read our article, Texas Medical Board Proposes Strict New Rules for Ketamine Therapy Clinics: What Physicians Need to Know.

If you are planning to open or invest in a ketamine clinic, contact Hendershot Cowart P.C. at (713) 783-3110 or contact us online to discuss how the proposed rules may affect your plans.

Who Can Own a Ketamine Clinic?

In Texas, ownership of a ketamine clinic is governed by Corporate Practice of Medicine (CPOM) doctrine. This doctrine limits who can open medical practices and provide medical services. Because ketamine treatment is considered the practice of medicine in Texas, the CPOM doctrine requires that a licensed physician own ketamine clinics.

That said, many people can be involved in operating a ketamine clinic, including non-licensed individuals. In particular, a non-licensed individual or individuals may own a management company that provides physician-owned ketamine clinics with administrative services, provided it is properly structured.

If you are not a licensed physician but are looking to open a ketamine clinic in Texas, our attorneys can help you design an ownership structure that complies with the Texas CPOM. 

Who Can Administer Ketamine?

A licensed physician with current unrestricted DEA registration (Schedules II–V) can administer ketamine treatments. A physician can also delegate administration to a certified registered nurse anesthetist (CRNA). However, because ketamine is a scheduled drug, the physician must be present during the administration. 

The Texas Medical Board has additional requirements that adhere to the American Society of Anesthesiologists’ Statement on Granting Privileges for Administration of Moderate Sedation to Practitioners Who are Not Anesthesia Professionals. Physicians must also ensure that each administration of ketamine involves a documented therapeutic benefit for the patient.

Your healthcare attorney can guide you on Texas Medical Board and other regulatory requirements for the administration and supervision of ketamine treatments.

Is Ketamine an FDA-Approved Treatment for Depression?

Currently, the FDA has only approved ketamine as a sole anesthetic agent for diagnostic and surgical procedures (note: esketamine, a nasal spray, has been approved for use in treatment-resistant depression cases). This does not mean that it cannot be used, at the discretion of the administering or prescribing physician, for other non-FDA-approved indications (this is called off-label use).

Due to increased interest in ketamine’s off-label use possibilities, the American Psychiatric Association (APA) Council of Research Task Force on Novel Biomarkers and Treatments has released a consensus statement to help clinicians safely provide ketamine infusion therapy.

The APA guidance outlines key areas such as:

• Appropriate patient selection
• Suitable treatment settings
• Clinician experience and training
• Treatment plans

Which Licenses Do You Need to Open a Ketamine Clinic in Texas?

In Texas, only licensed physicians can own a ketamine clinic. Clinicians working under the supervision of a physician or anesthesiologist to monitor patients during moderate sedation can be a registered nurse or a licensed physician assistant.

There are no facility license requirements for ketamine clinics; however, the APA has made recommendations on how to appropriately equip and staff a ketamine treatment facility in its consensus statement. For example, clinical settings should provide sufficient means of monitoring the patient’s basic cardiovascular and respiratory function and provide for immediate care if necessary.

What Is the Best Structure & Entity Selection for a Ketamine Clinic?

How to structure your ketamine clinic will depend on the specific licensing held by the interested investors. Physician-owned clinics are frequently set up as PLLCs, while a non-physician-owned management services organization should typically be established as an LLC. At the same time, a management services agreement can establish a service relationship between the two entities.

Reminder: A management company established by non-physicians may only operate the non-clinical aspects of the ketamine clinic. This company may also provide nursing services to the clinic through an employment or independent contractor agreement. That said, the ketamine clinic itself must be owned by a licensed physician. That physician must also be responsible for all patient care and setting the fees for all medical services provided by the clinic.

Can Ketamine Be Administered via a Mobile Clinic?

Texas regulations do address mobile anesthesia providers, but those rules were written before ketamine became a recognized treatment for psychiatric conditions.

Our attorneys can review your business model and advise you on compliance with Texas code.

Do I Need a Lawyer to Open a Ketamine Clinic in Texas?

If you are considering starting or investing in a ketamine clinic in Texas, working with an attorney is strongly recommended to protect your license and ensure that your clinic complies with all federal, state, and local laws and regulations. Hendershot Cowart P.C. can help.

How Our Attorneys Can Help: Ketamine Clinic Compliance and Regulatory Guidance

Setting up a ketamine therapy clinic in Texas requires more than finding a location and hiring staff. You are navigating corporate practice of medicine restrictions, DEA and TMB licensing requirements, physician delegation and supervision rules, and – with proposed 2026 rules moving toward adoption – a mandatory registration framework that will reshape how every non-exempt PKT clinic in Texas operates.

Hendershot Cowart P.C. – Texas healthcare attorneys since 1987 – helps physicians, healthcare investors, and clinical operators build compliant ketamine clinic structures from the ground up, and helps existing clinics identify and close compliance gaps before the proposed rules take effect.

Our medical practice setup services include:

• Entity formation (PLLC, PA, LLP)
• Regulatory compliance (Stark Law, Anti-Kickback Statute, HIPAA, state licensing)
• Management services agreements and management services organization (MSO) structures designed to comply with Texas's corporate practice of medicine doctrine
• Physician employment agreements, non-compete agreements, medical director agreements, and independent contractor agreements for healthcare providers
• Patient forms and required notices
• Partnership structures, buy-in arrangements, and compensation plans
• Governance documents, buyout formulas, and succession planning
• Medical space leases, equipment agreements, and billing contracts

We have worked with a wide range of healthcare professionals on ketamine therapy clinic matters, including physicians, APRNs, physician assistants, psychiatric mental health nurses, and non-physician investors structuring compliant ownership arrangements.

We help physicians and healthcare investors structure ketamine therapy clinics that are built to last. Call (713) 783-3110 or contact us online to schedule a consultation today.