The answer depends on three things. Whether the service is medical or cosmetic, where your med spa is located, and whether you’re selling products.

Medical services performed by a licensed medical professional are not subject to sales tax anywhere in New York, including New York City. This includes treatments like Botox injections, dermal fillers, laser hair removal for medical conditions, and IV therapy when administered by a physician, nurse practitioner, or other qualified medical provider. The key is that the service must be medical in nature and performed by or under the supervision of a licensed medical professional.

Purely cosmetic services that don’t qualify as medical treatments follow New York’s personal service rules. Outside of New York City, these services are exempt from sales tax. In New York City, personal and cosmetic services are taxable at 4.5%. This means a facial, body treatment, or cosmetic laser service would be tax-exempt on Long Island but taxable if you operate in Manhattan or Brooklyn.

Retail product sales are taxable regardless of location. When you sell skincare products, supplements, or any other physical goods, you need to collect sales tax at the combined state and local rate for your area. On Long Island, this is typically around 8.625% depending on the county.

The challenge for salons and spas like med spas is that you likely offer a mix of all three categories. A single client visit might include a medical Botox treatment with no tax, a cosmetic facial with no tax on Long Island, and a skincare product purchase that is taxable. Your point of sale system needs to handle each category correctly.

Getting this wrong creates problems in both directions. Collecting tax on exempt services means you’ve overcharged clients and need to refund them. Failing to collect tax on taxable sales means you owe the state money you never collected.

If you’re a med spa owner on Long Island, work with someone who understands these sales tax distinctions. Good bookkeeping for service based businesses means your accounting system tracks revenue by category so you can accurately report taxable versus non-taxable sales. Proper categorization from the start saves headaches if you’re ever audited.