Who can inject — in all 50 states.
The 2026 at-a-glance reference for practice owners: who may inject neurotoxins and fillers, RN and NP/PA authority, ownership rules, and how strict each state is. 51 jurisdictions, one page.
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9 strict · 35 moderate · 7 lenient
| State | Strictness | Who can inject | RN inject? | NP / PA authority | Ownership |
|---|---|---|---|---|---|
| Alabama | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice limited | Lenient; MSO/non-physician ownership permitted with physician medical director |
| Alaska | Lenient | MD, DO, NP, PA, RN with minimal supervision requirements | Yes, RNs may inject with general physician oversight; specific delegation protocols vary | NP/PA may practice with broad autonomy; physician collaboration not always required | Lenient; non-physician ownership and MSO models widely permitted |
| Arizona | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, RNs may inject under physician delegation and supervision | NP/PA may inject and practice with physician collaboration; independent practice limited | Moderate; MSO/non-physician ownership permitted with physician medical director |
| Arkansas | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, RNs may inject under physician delegation; supervision requirements vary by board interpretation | NP/PA may inject under physician collaboration; independent practice limited | Moderate; MSO/non-physician ownership permitted with physician medical director |
| California | Strict | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation and supervision; must follow written protocols | NP/PA may inject under physician supervision; independent practice not permitted for injectables | Strict; Corporate Practice of Medicine doctrine enforced—non-physicians cannot own; MSO structure required |
| Colorado | Moderate | MD, DO, NP, PA, RN under supervision or delegation | Yes, under physician supervision or delegation; scope varies by board interpretation | NP/PA may inject under physician collaboration; independent practice for injectables unclear—verify with board | Lenient; no strict CPOM doctrine; non-physicians may own with physician involvement |
| Connecticut | Moderate | MD, DO, NP, PA, RN under physician supervision or delegation | Yes, under physician supervision or delegation; scope defined by nursing board rules | NP/PA may inject under physician collaboration; independent practice for injectables not clearly permitted | Lenient; no strict CPOM doctrine; non-physicians may own with physician involvement |
| Delaware | Moderate | MD, DO, NP, PA, RN under physician supervision or delegation | Yes, under physician supervision or delegation; scope defined by Delaware Board of Nursing | NP/PA may inject under physician collaboration; independent practice for injectables not clearly permitted | Lenient; no strict CPOM doctrine; non-physicians may own with physician involvement |
| District of Columbia | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation and supervision | NP/PA may inject under physician collaboration/supervision | Lenient; MSO/non-physician ownership permitted with physician oversight |
| Florida | Lenient | MD, DO, NP, PA, RN, LPN under physician delegation | Yes, RNs and LPNs can inject under physician delegation; no specific training mandate beyond licensure | NP/PA may inject independently or under physician collaboration; broad independent authority | Lenient; non-physician ownership and MSO structures widely permitted |
| Georgia | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, RNs can inject under physician delegation and supervision | NP/PA may inject under physician collaboration/supervision; independent practice limited | Moderate; physician-owned or MSO with physician oversight permitted |
| Hawaii | Strict | MD, DO, NP, PA; RN injection authority unclear—verify with board | Unclear; Hawaii Board of Nursing guidance on RN injection of fillers/neurotoxins varies by interpretation—verify with counsel | NP/PA may inject under physician collaboration; independent practice limited | Strict; physician-owned or strict MSO structure required |
| Idaho | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice limited | Lenient; MSO/non-physician ownership permitted with physician medical director |
| Illinois | Strict | MD, DO only; RN/NP/PA may not inject neurotoxins or fillers | No; RNs cannot inject neurotoxins or fillers in Illinois | NP/PA cannot inject; limited to supportive roles; physician collaboration required for any clinical decisions | Strict; Corporate Practice of Medicine doctrine enforced; physician ownership or MSO with tight physician control required |
| Indiana | Moderate | MD, DO, NP, PA, RN under physician delegation | Yes, under physician delegation and documented supervision protocols | NP/PA may inject under physician collaboration; independent practice not permitted | Lenient; MSO/non-physician ownership permitted with physician medical director oversight |
| Iowa | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and documented supervision | NP/PA may inject under physician collaboration; independent practice limited | Lenient; MSO/non-physician ownership permitted with physician medical director |
| Kansas | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | Requires physician collaboration/supervision for injections | Lenient; MSO/management structures permitted |
| Kentucky | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and direct supervision | Requires physician supervision for injections; independent practice limited | Lenient; MSO/management structures permitted |
| Louisiana | Strict | MD/DO only; RN/NP/PA may not inject neurotoxins/fillers | No; RNs cannot inject neurotoxins or fillers in Louisiana | Cannot inject neurotoxins/fillers; limited to supportive roles | Strict; physician-owned or MSO with physician control required |
| Maine | Moderate | MD/DO, NP/PA under physician collaboration, RN under physician delegation | Yes, under physician delegation and supervision | May inject under physician collaboration; independent practice limited | Lenient; MSO/management structures permitted |
| Maryland | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | NP/PA require physician collaboration; cannot practice independently | Lenient; MSO/non-physician ownership permitted with physician oversight |
| Massachusetts | Strict | MD/DO only; RN/NP/PA may not inject | No; RNs cannot inject neurotoxins or fillers | NP/PA cannot inject; physician collaboration required for all clinical decisions | Strict; Corporate Practice of Medicine doctrine enforced—physician ownership or MSO with tight physician control |
| Michigan | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and standing orders | NP/PA may inject under physician collaboration; independent practice not permitted | Lenient; MSO/non-physician ownership permitted with physician oversight |
| Minnesota | Moderate | MD/DO, NP/PA under physician collaboration, RN under physician delegation | Yes, under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice not permitted | Lenient; MSO/non-physician ownership permitted with physician oversight |
| Mississippi | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | Requires physician collaboration/supervision | Lenient; MSO/management structures permitted |
| Missouri | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and direct supervision | Requires physician collaboration/supervision | Lenient; MSO/management structures permitted |
| Montana | Lenient | MD/DO, NP/PA independently or under supervision, RN under physician delegation | Yes, under physician delegation; NP/PA may inject with less restrictive supervision | May practice and inject with collaborative or independent authority depending on scope | Lenient; no strict CPOM enforcement |
| Nebraska | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | Requires physician collaboration/supervision | Moderate; physician involvement often expected |
| Nevada | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice varies by setting | Lenient; MSO/non-physician ownership permitted with physician medical director |
| New Hampshire | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation; scope varies by board interpretation | NP/PA may inject under physician collaboration; independent practice not clearly permitted | Lenient; MSO/non-physician ownership permitted with physician oversight |
| New Jersey | Strict | MD, DO, NP, PA; RN injection authority unclear/restricted | Unclear; RN injection of neurotoxins/fillers is not explicitly permitted and may be restricted to physician/NP/PA only | NP/PA may inject under physician collaboration; independent practice not permitted | Strict; physician ownership or MSO with strong physician control required |
| New Mexico | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and supervision; scope subject to board interpretation | NP/PA may inject under physician collaboration; independent practice not clearly permitted | Lenient; MSO/non-physician ownership permitted with physician oversight |
| New York | Strict | MD/DO, NP/PA under physician supervision, RN under physician delegation. | Yes, under direct physician delegation and supervision. | NP/PA may inject under physician collaboration; independent practice not permitted for injectables. | Strict; Corporate Practice of Medicine doctrine enforced—physician ownership or MSO structure required. |
| North Carolina | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation. | Yes, under physician delegation; RN must work under direct supervision or standing orders from a physician. | NP/PA may inject under physician supervision; independent practice for injectables not permitted. | Lenient; non-physicians may own a medspa if a physician is contracted as medical director/supervisor. |
| North Dakota | Lenient | MD/DO, NP/PA with physician collaboration, RN under delegation. | Yes, RN may inject under physician delegation; supervision requirements vary by procedure and facility protocol. | NP/PA may practice with physician collaboration; some independent authority for certain procedures depending on scope of practice agreement. | Lenient; Corporate Practice of Medicine doctrine not strictly enforced; non-physicians may own with physician oversight. |
| Ohio | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation. | Yes, under physician delegation; RN must follow standing orders or direct supervision from a physician. | NP/PA may inject under physician supervision; independent practice for injectables not permitted. | Lenient; non-physicians may own a medspa if a physician is contracted as medical director. |
| Oklahoma | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice limited | Lenient; MSO/management structures permitted; physician ownership not strictly required |
| Oregon | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; RN must have documented training and physician oversight | NP/PA may practice with physician collaboration; independent practice not permitted for injections | Lenient; MSO structures permitted; strict physician ownership not mandated |
| Pennsylvania | Strict | MD, DO, NP, PA under physician supervision; RN/LPN cannot inject | No; RNs and LPNs are prohibited from injecting neurotoxins and fillers in Pennsylvania | NP/PA may inject under physician supervision and collaboration; independent practice not permitted | Strict; Corporate Practice of Medicine enforced; physician ownership/MSO structure required |
| Rhode Island | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation and supervision; written protocol required | NP/PA may inject under physician collaboration; independent practice not permitted | Lenient; MSO/management structures permitted; strict physician ownership not mandated |
| South Carolina | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice varies by setting | Lenient; MSO/non-physician ownership permitted with physician medical director |
| South Dakota | Lenient | MD, DO, NP, PA, RN under physician supervision or delegation | Yes, under physician delegation; no specific training mandate | NP/PA may practice and inject with physician collaboration; some independent authority in rural/underserved areas | Lenient; non-physician ownership permitted with physician oversight |
| Tennessee | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician supervision and delegation; must follow written protocols | NP/PA may inject under physician collaboration; independent practice limited | Moderate; MSO model permitted with physician medical director |
| Texas | Lenient | MD, DO, NP, PA, RN, LPN under physician supervision or delegation | Yes, under physician delegation; no specific state-mandated injector training | NP/PA may inject and practice with physician collaboration; broad independent authority in some settings | Lenient; non-physician ownership permitted; physician-owned and MSO models both allowed |
| Utah | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice limited | Lenient; MSO/management structures permitted |
| Vermont | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation; specific protocols required | NP/PA may inject under physician collaboration; independent practice not clearly permitted | Lenient; MSO structures permitted |
| Virginia | Strict | MD, DO, NP, PA under physician supervision; RN only under direct physician oversight | Limited; RN may inject only under direct physician supervision and specific delegation | NP/PA may inject under physician collaboration; independent practice not permitted | Strict; physician ownership or MSO with strong physician control required |
| Washington | Moderate | MD, DO, NP, PA, RN under physician supervision or delegation | Yes, under physician delegation; RN must follow written protocols | NP/PA may inject under physician collaboration; independent practice authority limited | Lenient; MSO structures permitted with physician involvement |
| West Virginia | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation and supervision | Physician collaboration/supervision required | Lenient; MSO/management structures permitted |
| Wisconsin | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; specific scope varies by board interpretation | Physician collaboration/supervision required for injections | Lenient; MSO/management structures permitted |
| Wyoming | Lenient | MD, DO, NP, PA, RN; NP/PA may practice independently; RN requires physician delegation | Yes, under physician delegation; scope varies | Independent practice permitted; no physician collaboration required | Lenient; no strict CPOM enforcement; MSO/non-physician ownership permitted |
A general business reference, not legal advice — confirm specifics with your state board or counsel before acting. Rules change; see each state’s full profile for detail and sourcing.
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