Your Medical Director (MD) oversight fee moves between the standard and advanced service tiers based on your net revenue and the services on your treatment menu. This tier assignment is separate from the client volume adjustment, which changes with your average unique client count. Use this article to understand what sets your fee, how Moxie's biannual review works, and what to do if you disagree with a change.

❗ Important — This tier logic and review schedule apply to medspas with an in-house MD billed through Moxie. If you work with an external MD, you and your MD set your oversight fee directly, and none of this applies.

Knowing what drives a tier change helps you anticipate your MD oversight fee before it appears on your invoice, rather than being surprised by it. It also helps you tell the difference between a routine, policy-based fee update and something that needs to be corrected, and gives you a clear next step either way.\

Your MD oversight fee has two independent parts, and each can increase or decrease on its own:

Your service tier moves to advanced when both of the following are true:

If your treatment menu no longer includes an advanced service, or your trailing 6-month average revenue falls below $10,000, your tier reverts to standard. See What triggers a tier decrease below for both conditions.

Effective February 1, 2026, advanced services are:

✏️ Note — GLP-1 treatments (semaglutide, tirzepatide) are classified as a standard service. This changed as part of the February 1, 2026 update. If your medspa previously offered GLP-1 under the advanced tier, this reclassification on its own can move you back to standard.

Your base rate depends on your PC type as well as your service tier:

The following table shows the base monthly oversight fee by tier and PC type, before the client volume adjustment is applied:

✏️ Note — Being located in Illinois, North Carolina, or California doesn't automatically mean the Custom PC rate applies. It applies only if your medspa uses a Moxie-managed Custom PC. Your Provider Success Manager (PSM) can confirm your PC type.

The client volume adjustment increases your fee by $125 for every complete 100 unique clients in your average 6 months client count. Partial hundreds don't count toward the adjustment.

Twice a year, in January and July, Moxie's MD Operations team reviews your practice's trailing 6-month average net revenue, your treatment menu, and your average unique client count. Any resulting change takes effect on:

Your fee then stays the same for the full 6-month period until the next review. The review applies the same standardized fee structure to every in-house MD medspa. It is not a case-by-case negotiation.

Your service tier reverts from advanced to standard if either of the following happens:

The second condition applies even if your net revenue stays at or above $10,000. Offering an advanced service is a requirement for the advanced tier, not just a contributing factor. If your net revenue falls below $10,000, your client volume adjustment also stops applying until your revenue recovers above the threshold.

Ridgeline Aesthetics is on a Standard PC and offers laser treatments, averaging $14,000 in trailing 6-month revenue with 180 unique clients. At the January review, Moxie confirms both advanced-tier conditions are met, so the medspa's fee stays on the advanced tier: $1,200/month base (Standard PC) plus one client volume increment ($125), for a total of $1,325/month starting February 1.

In June, Ridgeline drops laser treatments from its menu to focus on injectables. Even though net revenue stays above $10,000, removing the advanced service means the July review moves Ridgeline back to the standard tier, effective August 1.

All in-house MDs and their affiliated Professional Corporations (PCs) have pre-approved Moxie's standardized MD fee structure. Individual fee negotiations are not available within the in-house MD program, including for providers who had a different fee arrangement with a previous MD. If you transitioned to a Moxie in-house MD from an independently contracted MD, any prior negotiated or discounted rate does not carry over.

Moxie's advanced service definitions are set at the policy level, not per medspa. If a service on your treatment menu was reclassified, it reflects a Moxie-wide definition change, not something specific to your practice's history. If you believe a service is listed on your menu but not something you actually offer, contact your PSM to have it removed. An advanced service still listed but not offered can trigger the advanced rate in error.

Moxie does not negotiate individual fee reductions, but a Temporary Reduced MD Fee may be available if your medspa is paused, transitioning, or facing a short-term financial or operational challenge. Reductions are approved for up to 3 months at a time. See Request a temporary reduced MD fee for how to apply.

If you believe your fee changed due to an error, such as a misclassified service or an incorrect revenue figure, contact your PSM or email [email protected]. Incorrect fee increases caused by service misclassification are one of Moxie's approved conditions for a fee correction. Include your medspa name and the specific fee or figure you're questioning so the MD Operations team can review it against your account.

Your fee increases when your net revenue and treatment menu meet the advanced-tier criteria, when your average unique client count reaches another complete 100 clients, or both. These changes are calculated during the biannual review and take effect on February 1 or August 1.

If your MD fee changed in January or February 2026, it was most likely due to the GLP-1 service categorization change, which moved GLP-1 treatments from the advanced tier to the standard tier. This was a one-time reclassification, not a standard biannual fee increase. If you have questions about this change, contact your PSM or email [email protected].

Your fee amount is your base rate for your service tier and PC type, plus $125 for every complete 100 unique clients in your average monthly client count, as long as your trailing 6-month average net revenue is at or above $10,000. For example, a Standard PC medspa on the standard tier with 230 average unique clients has 2 complete hundreds, so the fee is $650 plus $125 × 2 = $250, totaling $900/month. See the Base oversight fee by tier table above for your base rate.

Yes. Contact your PSM or email [email protected] to request the average net revenue and average unique client figures used in your most recent review.

No. Adding staff or a new injector does not automatically change your MD fee. Your fee is based on your service tier, PC type, and client volume adjustment, not your staffing level. Your fee only changes if your MD separately agrees to a different rate outside the standard fee structure.