Who can inject
MD/DO, NP/PA under physician supervision, RN under physician delegation
Registered nurses (RNs)
Yes, under physician delegation; must be supervised by MD/DO
Nurse practitioners & physician assistants
Requires physician supervision and collaboration
The exam that makes it legal
Required; in-person or telehealth permitted with physician discretion A valid order or good-faith exam by an authorized provider is what makes an injection lawful — not simply who holds the syringe.
Training expected
No state-mandated injector training beyond licensure.
What to verify in Missouri
Verify with the Missouri State Board of Nursing and Medical Board that your delegation and supervision protocols comply with current interpretations.
Primary source: Missouri State Board of Nursing and Missouri State Board of Registration for the Healing Arts
General business information for Missouri medical-spa owners, current as of 2026 — not legal advice. State boards update rules often; confirm specifics with the Missouri board (and your own counsel) before you act.