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 · 37 moderate · 5 lenient
| State | Strictness | Who can inject | RN inject? | NP / PA authority | Ownership |
|---|---|---|---|---|---|
| Alabama | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | NP/PA require physician collaboration and supervision | Lenient; MSO/non-physician ownership permitted with physician oversight |
| Alaska | Moderate | MD/DO, NP/PA under physician collaboration, RN under physician delegation | Yes, under physician delegation; scope varies by board interpretation | NP/PA require physician collaboration; independent practice limited | Lenient; non-physician ownership permitted with physician oversight |
| Arizona | Lenient | MD/DO, NP/PA independently or under collaboration, RN under physician delegation | Yes, under physician delegation; RNs have broad injection authority | NP/PA may practice independently or under collaboration; broad autonomy | Lenient; no strict CPOM enforcement; non-physician ownership permitted |
| Arkansas | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | NP/PA require physician supervision; independent practice not permitted | Moderate; MSO/physician-owned structures common; non-physician ownership possible with oversight |
| California | Strict | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation and direct supervision; must work in facility with supervising physician present or on-site | NP/PA may inject under physician supervision; independent practice not permitted for injectables | Strict; Corporate Practice of Medicine doctrine enforced—non-physicians cannot own/control medical decisions; MSO structure required |
| Colorado | Moderate | MD, DO, NP, PA, RN under physician supervision or delegation | Yes, under physician delegation; supervision model varies—may be on-site or remote depending on board interpretation | NP/PA may inject under physician collaboration; independent practice for injectables is not clearly permitted | Lenient; no strict CPOM enforcement; non-physicians may own with physician medical director |
| Connecticut | Moderate | MD, DO, NP, PA, RN under physician supervision or delegation | Yes, under physician delegation; on-site or remote supervision permitted under board guidance | NP/PA may inject under physician collaboration; independent practice not clearly permitted for injectables | Lenient; no strict CPOM enforcement; non-physicians may own with physician oversight |
| Delaware | Moderate | MD, DO, NP, PA, RN under physician supervision or delegation | Yes, under physician delegation; supervision model should be documented in writing | NP/PA may inject under physician collaboration; independent practice for injectables not clearly permitted | Lenient; no strict CPOM enforcement; non-physicians may own with physician oversight |
| 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; independent practice scope limited | Lenient; non-physician ownership permitted via management structure |
| Florida | Strict | MD, DO, NP, PA, RN under physician supervision; RN/LPN limited to certain injectables | Yes, but limited scope; RNs may inject under physician supervision, though some injectables restricted to NP/PA/MD | NP/PA may inject under physician collaboration; independent practice prohibited for injectables | Strict; physician ownership or MSO with physician control required |
| Georgia | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; RN scope includes neurotoxins and fillers with proper supervision | NP/PA may inject under physician collaboration; independent practice not permitted for injectables | Lenient; non-physician ownership permitted via MSO/management structure with physician oversight |
| Hawaii | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; scope includes neurotoxins and fillers with documented supervision | NP/PA may inject under physician collaboration; independent practice scope limited | Lenient; non-physician ownership permitted via MSO/management structure |
| Idaho | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | Can practice under physician collaboration; independent practice limited | Lenient; MSO/management structures permitted |
| Illinois | Strict | MD/DO only; RN/LPN/NP/PA cannot inject neurotoxins or fillers | No; Illinois prohibits RN injection of neurotoxins and fillers | Limited; NP/PA cannot independently inject neurotoxins/fillers; physician collaboration required but does not permit delegation for injections | Strict; Corporate Practice of Medicine enforced; physician ownership or MSO with physician control required |
| Indiana | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and direct supervision | Can inject under physician supervision; independent practice not permitted for injections | Lenient; MSO/management structures permitted with physician oversight |
| Iowa | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | Can inject under physician supervision; independent practice not permitted for injections | Lenient; MSO/management structures permitted with physician oversight |
| 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; cannot practice independently for injectables | Lenient; MSO/management structures permitted |
| Louisiana | Strict | MD/DO only; NP/PA and RN cannot inject without physician present | No; RNs cannot inject neurotoxins or fillers | Limited; NP/PA cannot inject independently; physician must be physically present | 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 varies by scope | Lenient; MSO/management structures permitted |
| Maryland | 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, physician ownership not strictly required |
| Massachusetts | Strict | MD/DO only; NP/PA and RN may not inject neurotoxins/fillers | No; RNs cannot inject neurotoxins or fillers in Massachusetts | Cannot inject neurotoxins/fillers; limited to supportive clinical roles | Strict; Corporate Practice of Medicine doctrine enforced—physician ownership or direct control required |
| Michigan | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and direct supervision | May inject under physician supervision; independent practice not permitted for injections | Lenient; MSO structures and non-physician ownership permitted with physician oversight |
| Minnesota | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | May inject under physician supervision; independent practice not permitted for injections | Lenient; MSO structures and non-physician ownership permitted with physician oversight |
| Mississippi | Strict | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under direct physician delegation and supervision | Requires physician collaboration and supervision | Strict — physician ownership/MSO structure required |
| Missouri | Moderate | MD/DO, NP/PA with physician supervision, RN under physician delegation | Yes, under physician delegation; specific training/protocols required | May practice with physician supervision; independent practice limited | Lenient — non-physician ownership permitted via MSO or management structure |
| Montana | Lenient | MD/DO, NP/PA independently or with physician collaboration, RN under NP/PA/physician delegation | Yes, under NP/PA or physician delegation; limited independent authority | May practice independently or with physician collaboration; broad scope | Lenient — no strict CPOM enforcement; non-physician ownership permitted |
| Nebraska | Moderate | MD/DO, NP/PA with physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | Requires physician supervision and collaboration | Moderate — non-physician ownership permitted via MSO with physician oversight |
| 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/management structures permitted; physician ownership not strictly required if proper supervision in place |
| New Hampshire | Moderate | MD, DO, NP, PA, RN under physician supervision or delegation | Yes, under physician delegation; scope varies by delegation agreement | NP/PA may practice with physician collaboration; independent practice limited | Lenient; MSO structures permitted with proper physician oversight |
| New Jersey | Strict | MD, DO, NP, PA under physician supervision; RN injection prohibited or highly restricted | No; RNs cannot inject neurotoxins or fillers in New Jersey | NP/PA may inject under physician supervision; independent practice not permitted | Strict; Corporate Practice of Medicine enforced; physician ownership or MSO with strict physician control required |
| New Mexico | Moderate | MD, DO, NP, PA, RN under physician supervision or delegation | Yes, under physician delegation; scope defined by delegation agreement | NP/PA may practice with physician collaboration; some independent authority permitted depending on setting | Lenient; MSO structures 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; physician ownership or MSO structure required. |
| North Carolina | Moderate | MD/DO, NP/PA with physician collaboration, RN under physician delegation. | Yes, under physician delegation; RN must work under a physician's standing orders or protocols. | NP/PA may inject under physician collaboration agreement; some independent authority permitted depending on practice setting. | Lenient; MSO and non-physician ownership permitted with physician oversight. |
| North Dakota | Lenient | MD/DO, NP/PA with or without physician supervision (varies by setting), RN under physician delegation. | Yes, under physician delegation; RN may inject with standing orders from a supervising physician. | NP/PA may practice with significant independence; physician collaboration required for some procedures but not all injectable settings. | Lenient; non-physician ownership and MSO structures permitted. |
| Ohio | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation. | Yes, under physician delegation; RN must inject under standing orders or protocols from a supervising physician. | NP/PA may inject under physician supervision; independent practice for injectables not permitted. | Moderate; MSO and non-physician ownership permitted with physician oversight. |
| Oklahoma | 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 |
| Oregon | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation; RN must work under standing orders or direct supervision | NP/PA may inject under physician collaboration; independent practice not permitted for injectables | Lenient; MSO/non-physician ownership permitted with physician oversight |
| Pennsylvania | Strict | MD, DO only; NP/PA/RN cannot inject | No; RNs cannot inject neurotoxins or fillers in Pennsylvania | NP/PA cannot inject; physician collaboration required but does not permit independent injectable authority | Strict; Corporate Practice of Medicine doctrine enforced; physician ownership or MSO with tight physician control required |
| Rhode Island | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and supervision; specific protocols required | NP/PA may inject under physician collaboration; independent practice not permitted for injectables | Lenient; MSO/non-physician ownership permitted with physician medical director |
| 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 limited | Lenient; MSO/non-physician ownership permitted with physician medical director |
| South Dakota | Lenient | MD, DO, NP, PA, RN under minimal supervision | Yes, RNs may inject with general physician oversight; specific delegation requirements unclear | NP/PA may practice with broad autonomy; physician collaboration not strictly mandated | Lenient; non-physician ownership and MSO models permitted |
| Tennessee | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation; specific scope defined by board rules | NP/PA may inject under collaborative agreement with physician; independent practice not permitted | Moderate; MSO model permitted with physician medical director |
| Texas | Moderate | MD, DO, NP, PA, RN under physician supervision or delegation | Yes, under physician delegation; scope varies by board interpretation | NP/PA may inject under collaborative agreement; independent practice permitted in limited circumstances | Lenient; MSO and non-physician ownership permitted with physician oversight |
| Utah | 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 |
| Vermont | 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 varies by setting | Lenient; MSO/management structures permitted |
| Virginia | 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 |
| Washington | 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 |
| West Virginia | 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 |
| Wisconsin | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; scope defined by board rules | NP/PA may inject under physician collaboration; independent practice not permitted | Lenient; MSO/management structures permitted |
| Wyoming | Lenient | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; Wyoming has permissive RN scope | NP/PA may practice with physician collaboration; independent practice permitted in some contexts | Lenient; MSO/management structures 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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