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, RN under physician supervision | Yes, under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice scope varies | Lenient; MSO/management structures permitted |
| Alaska | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation; specific scope varies by board interpretation | NP/PA may inject under collaborative agreement; independent practice scope limited | Lenient; MSO structures permitted |
| Arizona | Lenient | MD, DO, NP, PA, RN, LPN under appropriate supervision | Yes, RN may inject under NP/PA/MD supervision; LPN scope more limited | NP/PA may practice and inject with physician collaboration; independent practice permitted in some contexts | Lenient; no strict CPOM enforcement; MSO and non-physician ownership permitted |
| Arkansas | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and supervision; scope defined by board | NP/PA may inject under physician collaboration; independent practice limited | Moderate; MSO structures permitted with physician involvement |
| California | 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 supervision; independent practice limited | Strict; physician ownership or MSO structure required |
| Colorado | Moderate | MD/DO, NP/PA with physician collaboration, RN under physician delegation | Yes, under physician delegation; specific scope varies by facility protocol | NP/PA may inject with physician collaboration; some independent authority in limited contexts | Lenient; non-physician ownership permitted via MSO or management structure |
| Connecticut | Moderate | MD/DO, NP/PA with physician supervision, RN under physician delegation | Yes, under physician delegation; must be supervised by a physician | NP/PA may inject under physician supervision; independent practice not permitted for aesthetics | Moderate; non-physician ownership permitted with physician medical director |
| Delaware | Moderate | MD/DO, NP/PA with physician collaboration, RN under physician delegation | Yes, under physician delegation; scope defined by facility protocol and board guidance | NP/PA may inject with physician collaboration; independent practice varies by context | Lenient; non-physician ownership permitted 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 limited | Lenient; MSO/management structures permitted |
| Florida | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; must follow Board of Nursing rules | NP/PA may inject under physician collaboration; independent practice not permitted for injectables | Lenient; MSO structures permitted with physician oversight |
| Georgia | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; Georgia Board of Nursing permits RN injections with proper protocols | NP/PA may inject under physician collaboration; independent practice not permitted for injectables | Lenient; MSO/management structures permitted with physician oversight |
| Hawaii | Strict | MD, DO only; NP/PA/RN may not inject injectables | No; RNs may not inject neurotoxins or fillers in Hawaii | NP/PA may not independently practice or inject; physician collaboration required but injectables restricted to MDs/DOs | Strict; physician ownership or MSO with physician control required |
| Idaho | Moderate | MD/DO, NP/PA under physician supervision, RN under delegation | Yes, under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice limited | Lenient; MSO/management structures permitted |
| Illinois | Strict | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation; must be supervised by on-site or available physician | NP/PA may inject only under physician supervision; independent practice prohibited | Strict; 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 supervision | NP/PA may inject under physician supervision; independent practice not permitted | Lenient; MSO structures permitted with physician oversight |
| Iowa | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | NP/PA may inject under physician supervision; independent practice limited | Lenient; MSO structures permitted |
| Kansas | 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 |
| Kentucky | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation; specific scope defined by board rules | NP/PA may inject under physician supervision; independent practice not permitted for injectables | Lenient; MSO structures permitted with physician oversight |
| Louisiana | Strict | MD, DO only; RN/NP/PA may not inject neurotoxins or fillers | No; RNs cannot inject neurotoxins or fillers in Louisiana | NP/PA cannot independently inject; physician collaboration does not permit delegation of injectables | Strict; Corporate Practice of Medicine enforced; physician ownership or MSO with physician control required |
| Maine | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and supervision; scope defined by Board of Nursing | NP/PA may inject under physician collaboration; independent practice not permitted for injectables | Lenient; MSO structures permitted with physician oversight |
| Maryland | 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 |
| Massachusetts | Strict | MD, DO only; RN/NP/PA may not inject neurotoxins/fillers | No; RNs cannot inject neurotoxins or fillers in Massachusetts | NP/PA cannot inject neurotoxins/fillers; limited to supportive roles | Strict; physician ownership or direct control required |
| Michigan | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation and supervision; must follow delegation protocol | NP/PA may inject under physician collaboration; independent practice not permitted for injections | Lenient; MSO/management structures permitted with physician oversight |
| Minnesota | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; RN must be supervised by physician or NP/PA | NP/PA may inject under physician collaboration; independent practice limited | Lenient; MSO/management structures permitted |
| Mississippi | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under direct physician delegation and supervision | Requires physician collaboration and supervision | Lenient; non-physician ownership permitted via MSO structure |
| Missouri | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation; specific scope varies by board interpretation | Requires physician supervision; independent practice not permitted for aesthetics | Lenient; non-physician ownership permitted with physician oversight |
| Montana | Lenient | MD/DO, NP/PA with physician collaboration, RN under physician delegation | Yes, under physician delegation; Montana permits broad RN scope in aesthetics | May practice with physician collaboration; independent practice permitted in some contexts | Lenient; non-physician ownership widely permitted |
| Nebraska | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation | Yes, under physician delegation and supervision | Requires physician supervision; collaborative practice model required | Moderate; non-physician ownership permitted 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 limited | Lenient; MSO/non-physician ownership permitted with physician oversight |
| New Hampshire | Moderate | MD, DO, NP, PA, RN under physician supervision | Yes, under physician delegation and standing orders | NP/PA may inject under physician collaboration; independent practice not permitted for injectables | Moderate; physician involvement required but MSO structures permitted |
| New Jersey | Strict | MD, DO, NP, PA under physician supervision; RN injection prohibited | No; RNs are not permitted to inject neurotoxins or fillers | NP/PA may inject only under physician supervision and collaboration; independent practice prohibited | 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 standing orders | NP/PA may inject under physician collaboration; independent practice limited for injectables | 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; 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; specific protocols and supervision requirements vary by board interpretation. | NP/PA may inject under physician supervision; independent practice for injectables not clearly permitted. | Lenient; non-physician ownership permitted if physician supervision and delegation are documented. |
| North Dakota | Lenient | MD/DO, NP/PA with physician collaboration, RN under physician delegation. | Yes, under physician delegation; North Dakota permits broad RN scope in medical aesthetics. | NP/PA may inject with physician collaboration; some independent authority permitted depending on practice agreement. | Lenient; no strict Corporate Practice of Medicine enforcement; non-physician ownership permitted. |
| Ohio | Moderate | MD/DO, NP/PA under physician supervision, RN under physician delegation. | Yes, under physician delegation; Ohio permits RN injection of neurotoxins and fillers with proper supervision. | NP/PA may inject under physician supervision; independent practice for injectables not permitted. | Moderate; non-physician ownership permitted if physician supervision is documented. |
| Oklahoma | 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 |
| Oregon | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; RN must have training/competency documentation | NP/PA may inject under physician collaboration; independent practice limited | Lenient; MSO/non-physician ownership permitted with physician oversight |
| Pennsylvania | Strict | MD, DO, NP, PA under physician supervision; RN injection limited/prohibited | No, or only under very limited circumstances; varies by board interpretation — verify with counsel | NP/PA may inject under physician collaboration/supervision; independent practice not permitted | Strict; physician-owned or MSO with strong physician control required |
| Rhode Island | 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 |
| South Carolina | 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 |
| South Dakota | Lenient | MD, DO, NP, PA, RN under delegation; RN may inject with physician oversight | Yes, RN may inject under physician delegation | NP/PA may practice and inject with physician collaboration; independent practice permitted in some settings | Lenient; MSO and non-physician ownership permitted |
| Tennessee | Moderate | MD, DO, NP, PA, RN under physician delegation/supervision | Yes, RN may inject under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice limited | Moderate; MSO structures permitted with physician involvement |
| Texas | Moderate | MD, DO, NP, PA, RN under physician delegation; RN requires physician supervision | Yes, RN may inject under physician delegation and supervision | NP/PA may inject under physician collaboration; independent practice limited | Moderate; MSO structures permitted with physician involvement |
| 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 | Yes, under physician supervision and delegation | NP/PA may inject under collaborative agreement with physician | Lenient; management structures permitted |
| Virginia | Strict | MD, DO, NP, PA under physician supervision; RN only under direct physician supervision | Limited; RN may inject only under direct physician supervision on-site | NP/PA may inject under physician collaboration agreement; independent practice restricted | Strict; physician-owned or MSO with strong physician control |
| Washington | Moderate | MD, DO, NP, PA, RN under physician supervision/delegation | Yes, under physician delegation; on-site presence may vary | NP/PA may inject under physician collaboration; independent practice limited | Lenient; MSO/management structures permitted |
| West Virginia | Moderate | MD/DO, NP/PA under physician supervision, RN under physician 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 under physician supervision, RN under physician delegation | Yes, under physician delegation; must be supervised | NP/PA may inject under physician supervision; independent practice not permitted | Lenient; MSO structures permitted |
| Wyoming | Lenient | MD/DO, NP/PA independently or under physician collaboration, RN under physician delegation | Yes, under physician delegation; supervision requirements less stringent than other states | NP/PA may practice and inject independently or under physician collaboration | Lenient; no strict CPOM enforcement |
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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