In states where cosmetic products are taxed, does anyone charge sales tax to the patient? Here in Virginia, Botox is not taxed, but dermal fillers and other retail items are subject to state sales tax. I have not charged tax to patients, but am considering doing so, as it has become a significant burden.

There is no sales tax on medical procedures. You can not just arbitrarily charge sales tax. If a tax is charged it is paid to the appropriate government agency and still does not benefit the merchant , it only raises the overall costs to the patients. Sales taxes are charged on products that are sold and are not prescription medications .