{ "name": "Medical-Spa Regulation by U.S. State", "description": "Who can inject, supervision, medical-director, good-faith-exam, and ownership rules for medical spas in all 50 states + DC.", "source": "Inside MedSpa", "homepage": "https://insidemedspa.com/state-regulations/", "license": "Free to use with attribution and a link back to insidemedspa.com. Informational, not legal advice.", "attribution": "Data via Inside MedSpa — https://insidemedspa.com/state-regulations/", "updated": "2026-08-24T16:11:31.508Z", "count": 51, "states": [ { "state": "Alabama", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice scope varies", "medical_director": "Required for RN/LPN injectors; physician oversight mandatory", "good_faith_exam": "Required; in-person or telehealth permitted", "gfe_telehealth": "Allowed for initial visit if physician-patient relationship established", "ownership": "Non-physicians may own via MSO or management agreement with supervising physician", "corporate_practice": "Lenient; MSO/management structures permitted", "url": "https://insidemedspa.com/state-regulations/alabama/" }, { "state": "Alaska", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision", "rn_can_inject": "Yes, under physician delegation; specific scope varies by board interpretation", "np_pa_authority": "NP/PA may inject under collaborative agreement; independent practice scope limited", "medical_director": "Required for RN/LPN injectors; physician oversight mandatory", "good_faith_exam": "Required; in-person preferred, telehealth varies by board interpretation", "gfe_telehealth": "Conditional; telehealth GFE permitted in limited circumstances with physician discretion", "ownership": "Non-physicians may own via MSO or management agreement with supervising physician", "corporate_practice": "Lenient; MSO structures permitted", "url": "https://insidemedspa.com/state-regulations/alaska/" }, { "state": "Arizona", "strictness": "Lenient", "who_can_inject": "MD, DO, NP, PA, RN, LPN under appropriate supervision", "rn_can_inject": "Yes, RN may inject under NP/PA/MD supervision; LPN scope more limited", "np_pa_authority": "NP/PA may practice and inject with physician collaboration; independent practice permitted in some contexts", "medical_director": "Not strictly required; physician supervision/collaboration required for RN/LPN injectors", "good_faith_exam": "Required; in-person or telehealth permitted", "gfe_telehealth": "Allowed for initial visit if physician-patient relationship established", "ownership": "Open; non-physicians may own and operate medical spas", "corporate_practice": "Lenient; no strict CPOM enforcement; MSO and non-physician ownership permitted", "url": "https://insidemedspa.com/state-regulations/arizona/" }, { "state": "Arkansas", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision", "rn_can_inject": "Yes, under physician delegation and supervision; scope defined by board", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for RN/LPN injectors; physician oversight mandatory", "good_faith_exam": "Required; in-person preferred, telehealth varies by board interpretation", "gfe_telehealth": "Conditional; telehealth GFE permitted with physician discretion and documented relationship", "ownership": "Non-physicians may own via MSO or management agreement with supervising physician", "corporate_practice": "Moderate; MSO structures permitted with physician involvement", "url": "https://insidemedspa.com/state-regulations/arkansas/" }, { "state": "California", "strictness": "Strict", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation", "rn_can_inject": "Yes, under direct physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician supervision; independent practice limited", "medical_director": "Required for most medical spa operations", "good_faith_exam": "Required; in-person exam mandatory before treatment", "gfe_telehealth": "Not allowed for initial aesthetic treatment visits", "ownership": "Physician-owned or MSO-managed with physician oversight", "corporate_practice": "Strict; physician ownership or MSO structure required", "url": "https://insidemedspa.com/state-regulations/california/" }, { "state": "Colorado", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA with physician collaboration, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation; specific scope varies by facility protocol", "np_pa_authority": "NP/PA may inject with physician collaboration; some independent authority in limited contexts", "medical_director": "Required for medical spa operations", "good_faith_exam": "Required; in-person or telehealth permitted under certain conditions", "gfe_telehealth": "Conditional; telehealth GFE allowed if physician-patient relationship established and state guidelines met", "ownership": "Non-physicians may own via MSO; physician involvement typically required for medical oversight", "corporate_practice": "Lenient; non-physician ownership permitted via MSO or management structure", "url": "https://insidemedspa.com/state-regulations/colorado/" }, { "state": "Connecticut", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA with physician supervision, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation; must be supervised by a physician", "np_pa_authority": "NP/PA may inject under physician supervision; independent practice not permitted for aesthetics", "medical_director": "Required for medical spa operations", "good_faith_exam": "Required; in-person exam generally required before treatment", "gfe_telehealth": "Not allowed; in-person exam required for initial aesthetic visit", "ownership": "Non-physicians may own with physician medical director on staff or under contract", "corporate_practice": "Moderate; non-physician ownership permitted with physician medical director", "url": "https://insidemedspa.com/state-regulations/connecticut/" }, { "state": "Delaware", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA with physician collaboration, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation; scope defined by facility protocol and board guidance", "np_pa_authority": "NP/PA may inject with physician collaboration; independent practice varies by context", "medical_director": "Required for medical spa operations", "good_faith_exam": "Required; in-person exam generally required", "gfe_telehealth": "Conditional; varies by board interpretation — verify with counsel", "ownership": "Non-physicians may own with physician medical director involvement", "corporate_practice": "Lenient; non-physician ownership permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/delaware/" }, { "state": "District of Columbia", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for medical spa operations; physician oversight mandatory", "good_faith_exam": "Required; in-person exam before treatment", "gfe_telehealth": "Not allowed for initial aesthetic treatment visits", "ownership": "Non-physicians may own via MSO/management structure with physician oversight", "corporate_practice": "Lenient; MSO/management structures permitted", "url": "https://insidemedspa.com/state-regulations/district-of-columbia/" }, { "state": "Florida", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation; must follow Board of Nursing rules", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice not permitted for injectables", "medical_director": "Required; physician must supervise aesthetic procedures", "good_faith_exam": "Required; in-person exam before treatment", "gfe_telehealth": "Not allowed for initial aesthetic treatment", "ownership": "Non-physicians may own via MSO/management structure with physician medical director", "corporate_practice": "Lenient; MSO structures permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/florida/" }, { "state": "Georgia", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation; Georgia Board of Nursing permits RN injections with proper protocols", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice not permitted for injectables", "medical_director": "Required; physician must supervise medical spa operations and injections", "good_faith_exam": "Required; in-person exam before treatment", "gfe_telehealth": "Not allowed for initial aesthetic treatment", "ownership": "Non-physicians may own via MSO/management structure with physician medical director", "corporate_practice": "Lenient; MSO/management structures permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/georgia/" }, { "state": "Hawaii", "strictness": "Strict", "who_can_inject": "MD, DO only; NP/PA/RN may not inject injectables", "rn_can_inject": "No; RNs may not inject neurotoxins or fillers in Hawaii", "np_pa_authority": "NP/PA may not independently practice or inject; physician collaboration required but injectables restricted to MDs/DOs", "medical_director": "Required; physician must directly supervise all aesthetic procedures", "good_faith_exam": "Required; in-person exam before treatment", "gfe_telehealth": "Not allowed for initial aesthetic treatment", "ownership": "Physician-owned or physician-controlled MSO; non-physician ownership not permitted", "corporate_practice": "Strict; physician ownership or MSO with physician control required", "url": "https://insidemedspa.com/state-regulations/hawaii/" }, { "state": "Idaho", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for medical spa operations", "good_faith_exam": "Required; in-person or telehealth permitted", "gfe_telehealth": "Allowed for initial visit with documented physician evaluation", "ownership": "Non-physicians may own via MSO with supervising physician", "corporate_practice": "Lenient; MSO/management structures permitted", "url": "https://insidemedspa.com/state-regulations/idaho/" }, { "state": "Illinois", "strictness": "Strict", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation; must be supervised by on-site or available physician", "np_pa_authority": "NP/PA may inject only under physician supervision; independent practice prohibited", "medical_director": "Required; physician must be on-site or immediately available", "good_faith_exam": "Required; in-person exam mandatory for initial visit", "gfe_telehealth": "Not allowed for initial visit; in-person physician exam required", "ownership": "Physician-owned or MSO with physician as controlling member", "corporate_practice": "Strict; physician ownership or MSO with physician control required", "url": "https://insidemedspa.com/state-regulations/illinois/" }, { "state": "Indiana", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician supervision; independent practice not permitted", "medical_director": "Required for medical spa operations", "good_faith_exam": "Required; in-person or telehealth permitted with physician approval", "gfe_telehealth": "Conditional; telehealth allowed if physician documents medical necessity and patient consent", "ownership": "Non-physicians may own via MSO with supervising physician", "corporate_practice": "Lenient; MSO structures permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/indiana/" }, { "state": "Iowa", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician supervision; independent practice limited", "medical_director": "Required for medical spa operations", "good_faith_exam": "Required; in-person or telehealth permitted", "gfe_telehealth": "Allowed if conducted by supervising physician with proper documentation", "ownership": "Non-physicians may own via MSO with supervising physician", "corporate_practice": "Lenient; MSO structures permitted", "url": "https://insidemedspa.com/state-regulations/iowa/" }, { "state": "Kansas", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice varies by setting", "medical_director": "Required for RN/LPN injectors; physician oversight mandatory", "good_faith_exam": "Required; in-person or telehealth permitted", "gfe_telehealth": "Allowed for initial visit if physician-patient relationship established", "ownership": "Non-physicians may own via MSO or management agreement with supervising physician", "corporate_practice": "Lenient; MSO/management structures permitted", "url": "https://insidemedspa.com/state-regulations/kansas/" }, { "state": "Kentucky", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision", "rn_can_inject": "Yes, under physician delegation; specific scope defined by board rules", "np_pa_authority": "NP/PA may inject under physician supervision; independent practice not permitted for injectables", "medical_director": "Required for facilities with RN/LPN injectors", "good_faith_exam": "Required; in-person preferred, telehealth varies by board interpretation", "gfe_telehealth": "Conditional; telehealth GFE permitted only if physician-patient relationship pre-exists and exam meets standard of care", "ownership": "Non-physicians may own via MSO or management agreement; physician medical director required", "corporate_practice": "Lenient; MSO structures permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/kentucky/" }, { "state": "Louisiana", "strictness": "Strict", "who_can_inject": "MD, DO only; RN/NP/PA may not inject neurotoxins or fillers", "rn_can_inject": "No; RNs cannot inject neurotoxins or fillers in Louisiana", "np_pa_authority": "NP/PA cannot independently inject; physician collaboration does not permit delegation of injectables", "medical_director": "Required; physician must be on-site or have direct oversight", "good_faith_exam": "Required; in-person exam by physician mandatory", "gfe_telehealth": "Not allowed; in-person exam by physician required before any treatment", "ownership": "Physician-only or physician-controlled MSO; non-physicians cannot own", "corporate_practice": "Strict; Corporate Practice of Medicine enforced; physician ownership or MSO with physician control required", "url": "https://insidemedspa.com/state-regulations/louisiana/" }, { "state": "Maine", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision", "rn_can_inject": "Yes, under physician delegation and supervision; scope defined by Board of Nursing", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice not permitted for injectables", "medical_director": "Required for facilities with RN/LPN injectors; physician oversight mandatory", "good_faith_exam": "Required; in-person or telehealth permitted if physician-patient relationship established", "gfe_telehealth": "Allowed if physician-patient relationship pre-exists and telehealth visit meets standard of care", "ownership": "Non-physicians may own via MSO or management agreement with supervising physician", "corporate_practice": "Lenient; MSO structures permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/maine/" }, { "state": "Maryland", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for RN/LPN injectors; physician supervision mandatory", "good_faith_exam": "Required; in-person or telehealth permitted", "gfe_telehealth": "Allowed for initial visit with physician oversight", "ownership": "Non-physicians may own via MSO/management structure with physician oversight", "corporate_practice": "Lenient; MSO/management structures permitted", "url": "https://insidemedspa.com/state-regulations/maryland/" }, { "state": "Massachusetts", "strictness": "Strict", "who_can_inject": "MD, DO only; RN/NP/PA may not inject neurotoxins/fillers", "rn_can_inject": "No; RNs cannot inject neurotoxins or fillers in Massachusetts", "np_pa_authority": "NP/PA cannot inject neurotoxins/fillers; limited to supportive roles", "medical_director": "Required; physician must be on-site or immediately available", "good_faith_exam": "Required; in-person exam mandatory before treatment", "gfe_telehealth": "Not allowed; in-person exam required", "ownership": "Physician-only or physician-controlled; non-physicians cannot own", "corporate_practice": "Strict; physician ownership or direct control required", "url": "https://insidemedspa.com/state-regulations/massachusetts/" }, { "state": "Michigan", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation and supervision; must follow delegation protocol", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice not permitted for injections", "medical_director": "Required for RN/LPN injectors; physician oversight mandatory", "good_faith_exam": "Required; in-person or telehealth permitted with physician oversight", "gfe_telehealth": "Conditional; telehealth GFE allowed if physician has adequate clinical information", "ownership": "Non-physicians may own via MSO/management structure with physician medical director", "corporate_practice": "Lenient; MSO/management structures permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/michigan/" }, { "state": "Minnesota", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation; RN must be supervised by physician or NP/PA", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for RN/LPN injectors; physician or NP/PA supervision mandatory", "good_faith_exam": "Required; in-person or telehealth permitted with physician oversight", "gfe_telehealth": "Allowed; telehealth GFE permitted if physician has adequate clinical information", "ownership": "Non-physicians may own via MSO/management structure with physician oversight", "corporate_practice": "Lenient; MSO/management structures permitted", "url": "https://insidemedspa.com/state-regulations/minnesota/" }, { "state": "Mississippi", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation", "rn_can_inject": "Yes, under direct physician delegation and supervision", "np_pa_authority": "Requires physician collaboration and supervision", "medical_director": "Required for RN/NP/PA injectors", "good_faith_exam": "Required, in-person preferred", "gfe_telehealth": "Not allowed for initial aesthetic treatment", "ownership": "Non-physicians may own via MSO with physician medical director", "corporate_practice": "Lenient; non-physician ownership permitted via MSO structure", "url": "https://insidemedspa.com/state-regulations/mississippi/" }, { "state": "Missouri", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation; specific scope varies by board interpretation", "np_pa_authority": "Requires physician supervision; independent practice not permitted for aesthetics", "medical_director": "Required for facilities with RN/NP/PA injectors", "good_faith_exam": "Required, in-person or telehealth conditional on physician judgment", "gfe_telehealth": "Conditional; physician may conduct telehealth GFE if clinically appropriate and documented", "ownership": "Non-physicians may own via MSO or management structure with supervising physician", "corporate_practice": "Lenient; non-physician ownership permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/missouri/" }, { "state": "Montana", "strictness": "Lenient", "who_can_inject": "MD/DO, NP/PA with physician collaboration, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation; Montana permits broad RN scope in aesthetics", "np_pa_authority": "May practice with physician collaboration; independent practice permitted in some contexts", "medical_director": "Not strictly required if physician is on-site or available for consultation", "good_faith_exam": "Required; in-person or telehealth permitted if clinically appropriate", "gfe_telehealth": "Allowed; telehealth GFE permitted if physician documents clinical appropriateness", "ownership": "Non-physicians may own; physician involvement not always required if protocols are followed", "corporate_practice": "Lenient; non-physician ownership widely permitted", "url": "https://insidemedspa.com/state-regulations/montana/" }, { "state": "Nebraska", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "Requires physician supervision; collaborative practice model required", "medical_director": "Required for facilities with delegated injectors", "good_faith_exam": "Required, in-person preferred", "gfe_telehealth": "Conditional; telehealth GFE may be permitted if physician determines it is clinically appropriate", "ownership": "Non-physicians may own via MSO or management structure with supervising physician", "corporate_practice": "Moderate; non-physician ownership permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/nebraska/" }, { "state": "Nevada", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for facilities offering injectable services", "good_faith_exam": "Required; in-person or telehealth allowed", "gfe_telehealth": "Allowed for initial visit with physician approval", "ownership": "Non-physicians may own via MSO structure with supervising physician", "corporate_practice": "Lenient; MSO/non-physician ownership permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/nevada/" }, { "state": "New Hampshire", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision", "rn_can_inject": "Yes, under physician delegation and standing orders", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice not permitted for injectables", "medical_director": "Required for medical spa operations", "good_faith_exam": "Required; in-person exam mandatory", "gfe_telehealth": "Not allowed; in-person exam required", "ownership": "Non-physicians may own with physician medical director; physician ownership preferred", "corporate_practice": "Moderate; physician involvement required but MSO structures permitted", "url": "https://insidemedspa.com/state-regulations/new-hampshire/" }, { "state": "New Jersey", "strictness": "Strict", "who_can_inject": "MD, DO, NP, PA under physician supervision; RN injection prohibited", "rn_can_inject": "No; RNs are not permitted to inject neurotoxins or fillers", "np_pa_authority": "NP/PA may inject only under physician supervision and collaboration; independent practice prohibited", "medical_director": "Required; physician must be actively involved", "good_faith_exam": "Required; in-person exam mandatory", "gfe_telehealth": "Not allowed; in-person exam required", "ownership": "Physician-owned or MSO with physician control; non-physician ownership severely limited", "corporate_practice": "Strict; physician ownership or MSO with strong physician control required", "url": "https://insidemedspa.com/state-regulations/new-jersey/" }, { "state": "New Mexico", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision", "rn_can_inject": "Yes, under physician delegation and standing orders", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited for injectables", "medical_director": "Required for medical spa operations", "good_faith_exam": "Required; in-person or telehealth allowed with physician approval", "gfe_telehealth": "Conditional; telehealth GFE allowed if physician establishes therapeutic relationship and documents rationale", "ownership": "Non-physicians may own via MSO with supervising physician", "corporate_practice": "Lenient; MSO structures permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/new-mexico/" }, { "state": "New York", "strictness": "Strict", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation.", "rn_can_inject": "Yes, under direct physician delegation and supervision.", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice not permitted for injectables.", "medical_director": "Required for any facility performing injectables; must be on-site or available for consultation.", "good_faith_exam": "Required; in-person exam mandatory before treatment initiation.", "gfe_telehealth": "Not allowed. In-person examination required before any injectable treatment.", "ownership": "Physician-owned or physician-controlled via MSO; non-physician ownership not permitted for injectable services.", "corporate_practice": "Strict; Corporate Practice of Medicine doctrine enforced—physician ownership or MSO structure required.", "url": "https://insidemedspa.com/state-regulations/new-york/" }, { "state": "North Carolina", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation.", "rn_can_inject": "Yes, under physician delegation; specific protocols and supervision requirements vary by board interpretation.", "np_pa_authority": "NP/PA may inject under physician supervision; independent practice for injectables not clearly permitted.", "medical_director": "Required for medical spa operations; physician supervision of delegated tasks is mandatory.", "good_faith_exam": "Required; in-person exam generally expected before treatment.", "gfe_telehealth": "Conditional. Telehealth may be permitted for follow-up or consultation, but initial exam typically requires in-person visit—verify with board.", "ownership": "Non-physicians may own; physician supervision required for injectable services.", "corporate_practice": "Lenient; non-physician ownership permitted if physician supervision and delegation are documented.", "url": "https://insidemedspa.com/state-regulations/north-carolina/" }, { "state": "North Dakota", "strictness": "Lenient", "who_can_inject": "MD/DO, NP/PA with physician collaboration, RN under physician delegation.", "rn_can_inject": "Yes, under physician delegation; North Dakota permits broad RN scope in medical aesthetics.", "np_pa_authority": "NP/PA may inject with physician collaboration; some independent authority permitted depending on practice agreement.", "medical_director": "Not strictly required; physician supervision/collaboration required for delegated injectables.", "good_faith_exam": "Required; in-person or telehealth exam permitted before treatment.", "gfe_telehealth": "Allowed. Telehealth good-faith exam is permitted for initial injectable consultation.", "ownership": "Open; non-physicians may own and operate medical spas with physician collaboration for injectables.", "corporate_practice": "Lenient; no strict Corporate Practice of Medicine enforcement; non-physician ownership permitted.", "url": "https://insidemedspa.com/state-regulations/north-dakota/" }, { "state": "Ohio", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation.", "rn_can_inject": "Yes, under physician delegation; Ohio permits RN injection of neurotoxins and fillers with proper supervision.", "np_pa_authority": "NP/PA may inject under physician supervision; independent practice for injectables not permitted.", "medical_director": "Required for medical spa operations; physician must oversee delegated injectable services.", "good_faith_exam": "Required; in-person exam expected before treatment.", "gfe_telehealth": "Conditional. Telehealth may be used for consultation, but initial exam typically requires in-person visit—verify with State Medical Board.", "ownership": "Non-physicians may own; physician supervision required for injectable services.", "corporate_practice": "Moderate; non-physician ownership permitted if physician supervision is documented.", "url": "https://insidemedspa.com/state-regulations/ohio/" }, { "state": "Oklahoma", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration/supervision", "medical_director": "Required; physician must oversee injector protocols", "good_faith_exam": "Required; in-person exam before treatment", "gfe_telehealth": "Not allowed; in-person exam required", "ownership": "Non-physicians may own via MSO structure with physician medical director", "corporate_practice": "Lenient; MSO/non-physician ownership permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/oklahoma/" }, { "state": "Oregon", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation; RN must have training/competency documentation", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for medical spa; physician must oversee aesthetic procedures", "good_faith_exam": "Required; in-person or telehealth allowed under certain conditions", "gfe_telehealth": "Conditional; telehealth GFE allowed if physician-patient relationship established and in-person follow-up scheduled", "ownership": "Non-physicians may own via MSO with physician medical director", "corporate_practice": "Lenient; MSO/non-physician ownership permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/oregon/" }, { "state": "Pennsylvania", "strictness": "Strict", "who_can_inject": "MD, DO, NP, PA under physician supervision; RN injection limited/prohibited", "rn_can_inject": "No, or only under very limited circumstances; varies by board interpretation — verify with counsel", "np_pa_authority": "NP/PA may inject under physician collaboration/supervision; independent practice not permitted", "medical_director": "Required; physician must oversee all aesthetic procedures and injections", "good_faith_exam": "Required; in-person exam mandatory before treatment", "gfe_telehealth": "Not allowed; in-person exam required", "ownership": "Physician-owned or MSO with physician as owner/controlling interest", "corporate_practice": "Strict; physician-owned or MSO with strong physician control required", "url": "https://insidemedspa.com/state-regulations/pennsylvania/" }, { "state": "Rhode Island", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration/supervision", "medical_director": "Required; physician must oversee medical spa operations and procedures", "good_faith_exam": "Required; in-person exam before treatment", "gfe_telehealth": "Not allowed; in-person exam required", "ownership": "Non-physicians may own via MSO structure with physician medical director", "corporate_practice": "Lenient; MSO/non-physician ownership permitted with physician oversight", "url": "https://insidemedspa.com/state-regulations/rhode-island/" }, { "state": "South Carolina", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice varies by setting", "medical_director": "Required for RN/LPN injectors; physician oversight mandatory", "good_faith_exam": "Required; in-person exam before treatment", "gfe_telehealth": "Not allowed; in-person exam required for initial visit", "ownership": "Non-physicians may own via MSO or management structure with physician oversight", "corporate_practice": "Lenient; MSO/management structures permitted", "url": "https://insidemedspa.com/state-regulations/south-carolina/" }, { "state": "South Dakota", "strictness": "Lenient", "who_can_inject": "MD, DO, NP, PA, RN under delegation; RN may inject with physician oversight", "rn_can_inject": "Yes, RN may inject under physician delegation", "np_pa_authority": "NP/PA may practice and inject with physician collaboration; independent practice permitted in some settings", "medical_director": "Not strictly required; physician oversight/delegation sufficient", "good_faith_exam": "Required; in-person or telehealth allowed", "gfe_telehealth": "Allowed; telehealth good-faith exam permitted for initial visit", "ownership": "Non-physicians may own; physician ownership not required", "corporate_practice": "Lenient; MSO and non-physician ownership permitted", "url": "https://insidemedspa.com/state-regulations/south-dakota/" }, { "state": "Tennessee", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician delegation/supervision", "rn_can_inject": "Yes, RN may inject under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for facilities with delegated injectors; physician oversight mandatory", "good_faith_exam": "Required; in-person exam before treatment", "gfe_telehealth": "Conditional; telehealth allowed only if physician has established relationship with patient", "ownership": "Non-physicians may own via MSO or management structure with physician oversight", "corporate_practice": "Moderate; MSO structures permitted with physician involvement", "url": "https://insidemedspa.com/state-regulations/tennessee/" }, { "state": "Texas", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician delegation; RN requires physician supervision", "rn_can_inject": "Yes, RN may inject under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required; physician medical director must oversee delegated injectors", "good_faith_exam": "Required; in-person exam before treatment", "gfe_telehealth": "Conditional; telehealth allowed only with established physician-patient relationship", "ownership": "Non-physicians may own via MSO or management structure with physician oversight", "corporate_practice": "Moderate; MSO structures permitted with physician involvement", "url": "https://insidemedspa.com/state-regulations/texas/" }, { "state": "Utah", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for RN/LPN injectors; physician oversight mandatory", "good_faith_exam": "Required; in-person or telehealth allowed", "gfe_telehealth": "Allowed for initial visit with physician oversight", "ownership": "Non-physicians via MSO/management structure; physician-owned also permitted", "corporate_practice": "Lenient; MSO/management structures permitted", "url": "https://insidemedspa.com/state-regulations/utah/" }, { "state": "Vermont", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision", "rn_can_inject": "Yes, under physician supervision and delegation", "np_pa_authority": "NP/PA may inject under collaborative agreement with physician", "medical_director": "Required for facilities with RN/LPN injectors", "good_faith_exam": "Required; in-person preferred, telehealth varies by practitioner", "gfe_telehealth": "Conditional; depends on practitioner and board interpretation", "ownership": "Non-physicians via MSO/management structure permitted", "corporate_practice": "Lenient; management structures permitted", "url": "https://insidemedspa.com/state-regulations/vermont/" }, { "state": "Virginia", "strictness": "Strict", "who_can_inject": "MD, DO, NP, PA under physician supervision; RN only under direct physician supervision", "rn_can_inject": "Limited; RN may inject only under direct physician supervision on-site", "np_pa_authority": "NP/PA may inject under physician collaboration agreement; independent practice restricted", "medical_director": "Required; physician must be actively involved in oversight", "good_faith_exam": "Required; in-person examination mandatory", "gfe_telehealth": "Not allowed for initial visit; in-person exam required", "ownership": "Physician-owned preferred; non-physician ownership restricted or requires strict MSO structure", "corporate_practice": "Strict; physician-owned or MSO with strong physician control", "url": "https://insidemedspa.com/state-regulations/virginia/" }, { "state": "Washington", "strictness": "Moderate", "who_can_inject": "MD, DO, NP, PA, RN under physician supervision/delegation", "rn_can_inject": "Yes, under physician delegation; on-site presence may vary", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for facilities with RN/LPN injectors", "good_faith_exam": "Required; in-person or telehealth allowed under certain conditions", "gfe_telehealth": "Conditional; allowed with physician oversight and proper documentation", "ownership": "Non-physicians via MSO/management structure permitted", "corporate_practice": "Lenient; MSO/management structures permitted", "url": "https://insidemedspa.com/state-regulations/washington/" }, { "state": "West Virginia", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation and supervision", "np_pa_authority": "NP/PA may inject under physician collaboration; independent practice limited", "medical_director": "Required for medical spa operations", "good_faith_exam": "Required; in-person exam before treatment", "gfe_telehealth": "Not allowed; in-person exam required", "ownership": "Non-physicians may own via MSO with physician oversight", "corporate_practice": "Lenient; MSO/management structures permitted", "url": "https://insidemedspa.com/state-regulations/west-virginia/" }, { "state": "Wisconsin", "strictness": "Moderate", "who_can_inject": "MD/DO, NP/PA under physician supervision, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation; must be supervised", "np_pa_authority": "NP/PA may inject under physician supervision; independent practice not permitted", "medical_director": "Required for medical spa operations", "good_faith_exam": "Required; in-person or telehealth allowed under certain conditions", "gfe_telehealth": "Conditional; telehealth GFE allowed if physician-patient relationship established and state rules met", "ownership": "Non-physicians may own via MSO with physician oversight", "corporate_practice": "Lenient; MSO structures permitted", "url": "https://insidemedspa.com/state-regulations/wisconsin/" }, { "state": "Wyoming", "strictness": "Lenient", "who_can_inject": "MD/DO, NP/PA independently or under physician collaboration, RN under physician delegation", "rn_can_inject": "Yes, under physician delegation; supervision requirements less stringent than other states", "np_pa_authority": "NP/PA may practice and inject independently or under physician collaboration", "medical_director": "Not required; physician oversight optional depending on ownership structure", "good_faith_exam": "Required; in-person or telehealth allowed", "gfe_telehealth": "Allowed; telehealth GFE permitted for initial visit", "ownership": "Open; non-physicians may own and operate medical spas", "corporate_practice": "Lenient; no strict CPOM enforcement", "url": "https://insidemedspa.com/state-regulations/wyoming/" } ] }