New Texas Ketamine Regulations: What They Mean for Patients
Texas Medical Board Proposes Stricter Oversight for Ketamine Therapy
On April 28, 2026, the Texas Tribune reported on proposed rules from the Texas Medical Board that would significantly change how ketamine therapy is delivered in Texas. The proposed regulations, expected to be published May 8 with a board vote in June, would require a physician to be physically present during every ketamine treatment and would ban in-home use of the drug. The rules are a response to the rapid growth of ketamine therapy across the state — including telehealth-only prescriptions, treatments administered in medical spas without proper oversight, and recreational use promoted in social settings. Under the current system, ketamine can be administered by a wide range of medical providers, sometimes without a physician involved at all. As our owner and clinical director Mary Moore told the Texas Tribune: the industry needs to be legitimized in order for insurance to get on board — and that starts with holding clinics to a higher standard.
What the Proposed Rules Would Require
The key changes in the Texas Medical Board's proposed regulations include:
- A physician must be physically present on site during every ketamine treatment — remote supervision or video monitoring would no longer meet requirements
- In-home use of parenteral ketamine (IV, IM, or subcutaneous) would be banned
- Clinics would need to register with the Texas Medical Board
- Monitoring equipment standards would align with office-based anesthesia settings
- Treatment would be restricted to formally diagnosed psychiatric conditions including treatment-resistant depression, PTSD, and suicidal ideation
These rules would affect many clinics that currently operate with nurse practitioners or physician assistants providing treatment while physicians remain off-site or available only by phone.
How Lake Austin Psychotherapy Already Meets These Standards
At Lake Austin Psychotherapy, we've operated with physician-level oversight from the beginning — not because the regulations required it, but because we believe it's the right way to deliver ketamine therapy.
Board-certified physician on site for every treatment. Dr. Truman Milling, MD, FACEP, our medical director, is a board-certified emergency physician with over 80 peer-reviewed publications. He is physically present and directly administers every ketamine infusion in our West Austin offices. There is no remote supervision, no video monitoring, and no delegation to unsupervised staff.
The right clinical skills at the bedside. We also believe the proposed rules should recognize the role of APRNs with ICU and procedural experience at the bedside, under physician practice oversight. Not every ketamine treatment requires a physician's hands — but it does require someone with airway management and critical care experience, not just training on a dummy. A psychiatrist who has never managed an airway is not the same as an emergency-trained APRN who has. What matters is clinical competency at the bedside, not just the letters after someone's name.
Clinical-grade monitoring throughout. Every infusion includes full medical monitoring — vital signs, oxygen saturation, and cardiac monitoring — consistent with the standards the new regulations would require. Dr. Milling noted in the Texas Tribune, what matters is the skill and experience of the person administering treatment — and our team brings both emergency medicine expertise and specialized training in ketamine-assisted psychotherapy.
Psychotherapy integrated with every treatment and in the weeks after. Our model pairs ketamine treatment with ongoing psychotherapy under the care of our licensed clinical team to capitalize on the metaplastic window in the weeks post-ketamine for more enduring outcomes. This is why our patients can go months on one low-dose infusion.
No at-home ketamine. We have never offered at-home ketamine programs. All treatments are administered in person at our private West Austin offices.
What This Means for Patients Considering Ketamine Therapy
If you're considering ketamine therapy in Texas, these proposed regulations are worth understanding. When evaluating a clinic, ask:
- Will an airway-experienced physician be physically present during your treatment?
- What are the physician's qualifications and experience with ketamine?
- Is the clinic prepared to meet the new monitoring and oversight standards?
- Does the clinic integrate ongoing psychotherapy with ketamine treatment, or is it medication-only?
At Lake Austin Psychotherapy, the answer to all of these has always been yes. The proposed regulations validate the approach we've taken since we began offering ketamine-assisted psychotherapy.
A Therapeutic Model, Not a Business Model
Many ketamine clinics sell packages of 6 infusions over two weeks as a standard protocol. That's a business model, not a therapeutic one. At Lake Austin Psychotherapy, 98% of our clients achieve enduring results from a single low-dose infusion paired with ongoing weekly psychotherapy — not just a single therapy session during the infusion, but sustained therapeutic work that builds on the neuroplasticity window ketamine creates. We treat based on your clinical response, not a predetermined package.
Schedule a Consultation
If you'd like to learn more about our ketamine therapy program or discuss whether it may be right for you, we offer a free, confidential one-hour consultation. Our physician-supervised approach means your care meets the highest clinical standards — today, and under any future regulations.
Schedule a FREE 1-hour consultation by clicking the button below. You can also reach us at info@lakeaustinpsychotherapy.com or call/text 512.666.1184.