Can a registered nurse inject Botox or filler, state by state
The same question, answered for 51 states from each state’s own law. States disagree on this, which is the point — an answer that is right in one is wrong next door. Every entry below is a statute or board rule we verified, most recently Sep 8, 2026.
Who treats · part of The Practice Perimeter
| State | What its rule says | Cited to |
|---|---|---|
| Alabama | The cited rules do not settle this — they only let a trained RN act as a Level 1 Delegate for non-ablative procedures using a device, energy source, chemical or modality named in a physician's written protocol, under supervision; injectables aren't named. | Ala. Admin. Code r. 540-X-11-.02(5) (definition of “Level 1 Delegate”) Sep 4, 2026 |
| Alaska | The cited rules do not settle this — they only let a physician, podiatrist, osteopath or PA delegate a single intramuscular, intradermal or subcutaneous injection with that delegator immediately on site; no cited rule sets an RN's own injection scope. | AS 08.68.805 (Delegation of nursing functions) Sep 5, 2026 |
| Arizona | Yes — an RN may administer Botox or filler as a nursing intervention, but only on a valid order from an authorized prescriber; the RN definition carries no prescriptive authority, which is granted separately to nurse practitioners. | A.R.S. §32-1601(24) Jul 26, 2026 |
| Arkansas | The cited rules do not settle this — they cover physician delegation to unlicensed employees and say a supervising or back-up physician should be available by immediate phone contact while a physician assistant treats; RN injectable scope isn't addressed. | 17 CAR § 140-1806 (Availability of supervising physician) Sep 4, 2026 |
| California | Yes — an RN may inject, but only while implementing a regimen ordered by a physician (or other authorized prescriber) or under standardized procedures; the RN may not do the required prior good-faith exam, which a physician, NP, or PA must perform first. | Cal. Bus. & Prof. Code §2725 Jul 26, 2026 |
| Colorado | The cited rules do not settle this — executing delegated medical functions is lawful nursing for an RN, but no cited rule names injectables. They do settle that an RN cannot prescribe the product: that authority is granted only to APRNs on the registry. | Colo. Rev. Stat. § 12-255-112(1)(a), (3)(a) Sep 2, 2026 |
| Connecticut | Yes — at a medical spa an RN may perform cosmetic injections and soft tissue fillers, executing the medical regimen under the direction of a physician, dentist or APRN; the initial in-person patient assessment must still be done by the physician, PA or APRN. | Conn. Gen. Stat. §20-87a(b)(2)(A) Sep 3, 2026 |
| Delaware | The cited rules do not settle this — they place advanced assessment, diagnosing, prescribing and ordering in the APRN scope, not the plain RN scope, and say nothing about whether an RN may inject botulinum toxin or filler on a prescriber's order. | 24 Del. C. §1902(b) Sep 3, 2026 |
| District of Columbia | Yes — cosmetic injection below the stratum corneum is medical practice, but an RN may do it where a licensed physician has authorized the procedure or the RN has the necessary training and experience; the RN scope definition itself is silent on injectables. | D.C. Code §3-1201.02(17) (“Practice of registered nursing” defined) Sep 3, 2026 |
| Florida | Yes — an RN may inject neurotoxins and fillers when the drug is prescribed or authorized by a duly licensed practitioner. An RN cannot prescribe it or decide to treat on her own, so every case needs a prescriber's order behind it. | Fla. Stat. §464.003 Jul 26, 2026 |
| Georgia | Only under a nurse protocol — a written agreement signed by the nurse and a licensed physician delegating authority to administer and order drugs; ordering is not prescribing, so the nurse can't write a prescription. The cited rules don't name injectables. | O.C.G.A. §43-34-23(a) Aug 17, 2026 |
| Hawaii | The cited rules do not settle this — they put the prescription and selection of therapeutic measures in APRN scope, which supersedes RN scope, and describe RN practice as carrying out a licensed prescriber's medical orders; no cited rule names Botox or filler. | Haw. Rev. Stat. § 457-2.7(a)-(b) Sep 8, 2026 |
| Idaho | The cited rules do not settle this — they only define the APRN, an RN with additional board-recognized training who may prescribe and administer pharmacologic agents; nothing cited states whether a plain RN may inject Botox or filler under a physician's order. | Idaho Code §54-1402(1) Sep 3, 2026 |
| Illinois | The cited rules do not settle this — they make botulinum toxin the practice of medicine and give full practice authority APRNs independent prescribing, but no cited rule states whether an RN may inject toxin or filler under physician delegation. | 225 ILCS 65/65-43 Aug 17, 2026 |
| Indiana | Yes — but only on order: an RN may administer Botox or filler under a regimen delegated by a physician or other authorized prescriber, and may never prescribe it independently. Cosmetic injection is itself the practice of medicine in Indiana. | Ind. Code §25-23-1-1.1 Jul 26, 2026 |
| Iowa | An ARNP practices to the full extent of their license, education and experience within their population foci. | Iowa Admin. Code r. 481—621.4(4) (Advanced registered nurse practitioners — scope) Sep 4, 2026 |
| Kansas | The cited rules do not settle this — they establish only that prescribing, recommending or furnishing drugs is practicing medicine, that delegation requires a person qualified by training or licensure, and that an RN may not hold out as an APRN. | Kan. Stat. Ann. §65-1130(a) Sep 3, 2026 |
| Kentucky | Only if a physician, PA, dentist, or APRN has prescribed it — RN scope covers administering prescribed medication and treatment, subject to further board limits; the cited rules set no Botox- or filler-specific standard or on-site supervision requirement. | Ky. Rev. Stat. §311.854(1) Sep 3, 2026 |
| Louisiana | The cited rules do not settle this — they only define an advanced practice registered nurse as an RN nationally certified in an advanced specialty. Nothing cited states whether an RN may inject neurotoxin or filler, or on what physician delegation terms. | La. Rev. Stat. §37:913(1) Sep 3, 2026 |
| Maine | The cited rules do not settle this — they say only that a nurse practitioner or nurse midwife qualifying as an advanced practice registered nurse may prescribe and dispense drugs under board rules; nothing cited addresses what an RN may inject. | 32 M.R.S. §2102(2-A) Sep 3, 2026 |
| Maryland | The cited rules do not settle this — a nurse practitioner may independently order and perform therapeutic measures and prescribe drugs, and RN practice covers administering medication and delegated medical functions, but neither rule names injectables. | Md. Code Regs. 10.27.07.03(A) (Nurse Practitioner — Scope and Standards of Practice) Sep 3, 2026 |
| Massachusetts | Only on a prescriber's order — nursing practice includes administering medication and treatment prescribed by a physician, PA, or authorized advanced practice nurse, and the RN stays directly accountable; the cited rules don't name Botox or filler. | Mass. Gen. Laws ch. 112, § 80B Sep 1, 2026 |
| Michigan | The cited rules do not settle this — none defines RN scope or names who may inject. They establish only that a licensee may delegate acts within the licensee's own scope, but not any act that requires the licensee's own level of education, skill, and judgment. | Mich. Comp. Laws § 333.17201 (scope of this section) Sep 2, 2026 |
| Minnesota | Yes — botulinum toxin and filler are legend drugs, so an RN may inject them when a licensed practitioner directs and supervises, or under a predetermined protocol that states the circumstances and covers a patient whose condition falls within it. | Minn. Stat. § 151.37, subd. 2(a) Sep 2, 2026 |
| Mississippi | Yes — an RN may administer medications and treatments prescribed by a licensed or legally authorized physician or dentist, as execution of the medical regimen; diagnosing and prescribing stay outside RN practice except as Board of Nursing rules provide. | Miss. Code Ann. § 73-15-5(2) Sep 8, 2026 |
| Missouri | Yes — an RN may administer injectables under a written collaborative practice arrangement with a physician that delegates drug administration, provided it is within the RN's scope, skill and training; only an APRN may be delegated authority to prescribe. | Mo. Rev. Stat. §335.016(2) Sep 3, 2026 |
| Montana | Yes — but only on an order: registered nursing practice covers administering medications and treatments prescribed by a physician, PA, APRN, or other authorized prescriber; the nursing chapter gives an RN no authority to prescribe or to practice medicine. | Mont. Admin. R. 24.159.1406(1) Sep 8, 2026 |
| Nebraska | The cited rules do not settle this — RN practice is defined as assessment, nursing diagnosis, and carrying out a plan of care, with no mention of injectables or who may order them; only esthetics and cosmetology licenses are expressly barred from injectables. | Neb. Rev. Stat. §38-2212(1), (2) Sep 3, 2026 |
| Nevada | Yes for fillers — an RN is on Nevada's exhaustive list of who may inject dermal or soft tissue fillers, if within scope and at a medical facility or a physician, PA, dentist, APRN or podiatrist office. The cited rules don't settle Botox. | Nev. Rev. Stat. §632.237(2) Sep 3, 2026 |
| New Hampshire | The cited rules do not settle this — they only define an APRN as a registered nurse separately licensed by the board, and define nursing in general terms; no cited provision says whether an RN may inject neurotoxin or filler, or on whose order. | N.H. Rev. Stat. §326-B:2, I Sep 3, 2026 |
| New Jersey | The cited rules do not settle injectables — they show only that a physician may direct a registered nurse to administer modalities, and delegating to a licensed provider still requires the physician's own exam, choice of treatment, vetting and supervision. | N.J.A.C. 13:35-6.14(a) Aug 17, 2026 |
| New Mexico | Yes — with appropriate education and training, an RN may perform aesthetic procedures including injections, only if delegated by and under indirect supervision of an APRN or other clinical supervisor, who must first examine, diagnose and set a treatment plan. | 16.12.14.8(D) NMAC (Education and scope of practice) Sep 4, 2026 |
| New York | Yes — a registered nurse may inject Botox or filler only by executing an order from a physician, nurse practitioner, or other authorized prescriber; the nurse must follow that medical regimen and may not vary it or treat on their own judgment. | N.Y. Educ. Law §6902(1) Aug 17, 2026 |
| North Carolina | Yes — botulinum toxin and filler injections are within an RN's scope when a physician, NP, PA or other prescriber evaluates the patient and orders the treatment; that evaluation can't be delegated to the injecting nurse, but the prescriber need not be on site. | NC Board of Nursing, Cosmetic/Aesthetic Dermatological Procedures Position Statement (rev. 9/2022) Aug 17, 2026 |
| North Dakota | The cited rules do not settle this — they only define an advanced practice registered nurse (NP, CRNA, nurse midwife, CNS) and let a licensed nurse delegate medication administration to exempt persons; neither addresses an RN injecting Botox or filler. | N.D.C.C. § 43-12.1-02 (Definition of advanced practice registered nurse) Sep 5, 2026 |
| Ohio | The cited rules do not settle this — they give certified nurse practitioners prescribing authority in collaboration with a physician, and the injection-delegation chapter covers unlicensed persons, not RNs; none addresses an RN injecting Botox or filler. | Ohio Rev. Code §4723.43(B) Aug 17, 2026 |
| Oklahoma | The cited rules do not settle this — they only grant APRNs (nurse practitioners, CNSs, nurse-midwives) with 6,240 clinical hours independent prescriptive authority and place injections outside cosmetology scope; RN administration is not addressed. | Okla. Stat. tit. 59, § 567.4c(A) (Independent prescriptive authority for APRNs) Sep 5, 2026 |
| Oregon | The cited rules do not settle this — nursing practice is defined to include executing medical orders from a physician, nurse practitioner, or other authorized prescriber, but nothing cited addresses Botox or fillers; only NPs are given prescribing authority. | Or. Rev. Stat. §678.010(9) (“Practice of nursing” defined) Sep 3, 2026 |
| Pennsylvania | Pennsylvania is a collaborative-agreement state for nurse practitioners, and it is prescriptive about the paperwork: the agreement must name a substitute physician for when the collaborating one is unavailable. | 49 Pa. Code §21.283(a) Aug 17, 2026 |
| Rhode Island | The cited rules do not settle this — they define advanced practice registered nursing as an expanded, independent scope, but set no RN injection authority; the Botox and filler carve-out only removes those shots from "surgery," not from who may perform them. | R.I. Gen. Laws §5-34-3(2) Sep 3, 2026 |
| South Carolina | The cited rules do not settle this — they only define the written practice agreement under which an APRN (NP, CNM, or CNS) may perform specified medical acts with a physician; nothing cited addresses what a registered nurse may inject. | S.C. Code §40-33-20(45) (“Practice agreement” defined) Sep 3, 2026 |
| South Dakota | South Dakota enumerates the certified nurse practitioner scope as a list of powers ADDED to the registered nurse scope. | S.D. Codified Laws §36-9A-12 Sep 3, 2026 |
| Tennessee | The cited rules do not settle this — they only require a physician supervising a prescribing nurse practitioner to hold an unencumbered Tennessee license, the same standard as for PAs; RN scope sits with the Board of Nursing rules not cited here. | Tenn. Comp. R. & Regs. 0880-02-.14(12), referring to 0880-02-.18(1) and 0880-06-.02(1) Sep 2, 2026 |
| Texas | Yes — an RN who is not an APRN may inject Botox or filler as a delegated act, but not diagnose or prescribe, and only with an order from an appropriately licensed practitioner, documented competency, written policies, and medical and nursing support available. | Tex. BON Position Statement 15.11 Jul 26, 2026 |
| Utah | The cited rules do not settle this — an RN may perform nonablative cosmetic procedures under general supervision by an unrestricted-licensed physician or APRN, but no cited rule says neurotoxin or filler injection is one; RNs generally can't prescribe it. | Utah Admin. Code R156-31b-502(1)(c) (Unprofessional conduct) Sep 4, 2026 |
| Vermont | The cited rules do not settle this — they define APRNs and require a collaborating-provider agreement for those under 24 months/2,400 hours, and bar delegating care to anyone not qualified by training or license, but say nothing on RN injection authority. | Vt. Stat. tit. 26, §1613(a)(1) (Transition to practice) Sep 3, 2026 |
| Virginia | The cited rules do not settle this — they give no RN scope rule; they establish only that advanced practice nursing needs a joint Board of Medicine/Nursing license, and that toxin and filler are prescription drugs requiring a prescriber's bona fide exam. | Va. Code § 54.1-2957(B) Sep 2, 2026 |
| Washington | Yes — a physician may delegate cosmetic injections to a properly trained registered nurse; if the product is used off-label the physician must be on site for the whole procedure, and if it is FDA-approved for that use, reachable within 30 minutes. | Wash. Rev. Code 18.79.050 Sep 2, 2026 |
| West Virginia | The cited rules do not settle this — they only cover APRN prescriptive authority (45 pharmacology hours, then board authorization to prescribe under a collaborative agreement with a physician). Nothing here addresses an RN administering injectables. | W. Va. Code §30-7-15b(a)(3) Sep 3, 2026 |
| Wisconsin | The cited rules do not settle this — RN scope sits in ch. 441, not covered here. They establish only that if a physician delegates the injection, that physician must be competent to perform it and have evidence the nurse is too, or it's unprofessional conduct. | Wis. Admin. Code Med §§ 10.02(1) and 10.03(1)(L) Sep 2, 2026 |
| Wyoming | The cited rules do not settle this — they confirm an APRN may prescribe and administer prescription drugs, and that administering such drugs is practicing medicine, but nothing here sets out whether an RN may inject under a physician's order or delegation. | Wyo. Stat. Ann. §33-21-120(a)(i)(A) Sep 3, 2026 |
Every state, in its own words
Alabama
ALABAMA SORTS THE STAFF INTO TWO NAMED TIERS FOR ENERGY-DEVICE WORK. A LEVEL 1 DELEGATE is a physician assistant, a certified registered nurse practitioner or a registered nurse authorized in a written job description or protocol to use a specific device for non-ablative procedures, who has met the Level 1 educational requirements. A LEVEL 2 DELEGATE is an LPN or a medical assistant — the rule names aestheticians, cosmetologists and laser technicians in that tier — on the same written-authorization and education conditions. Separately, a certified registered nurse practitioner in collaborative practice may evaluate health status from a comprehensive history and physical examination, formulate a working diagnosis and develop a treatment plan.
Ala. Admin. Code r. 540-X-11-.02(5) (definition of “Level 1 Delegate”) · verified Sep 4, 2026
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The Alaska Nursing statutes let a registered, advanced practice registered or practical nurse delegate nursing duties to other persons INCLUDING UNLICENSED ASSISTIVE PERSONNEL, under board regulations, and a delegate may perform those duties without any nursing license of their own provided they meet the board’s requirements. AS 08.68.850 defines an advanced practice registered nurse as one certified to perform acts of medical diagnosis and to prescribe and dispense medical, therapeutic or corrective measures under board regulations. AND THE REGULATION THAT WOULD REQUIRE PHYSICIAN COLLABORATION IS NO LONGER THERE. In the board’s advanced-practice article the collaboration slot reads “12 AAC 44.410. Collaborative relationship. Repealed 12/1/84.”, as does the remote-location rule beside it; prescriptive authority runs from the board to the nurse on the nurse’s own application; and scope is set by the national certifying bodies the board recognizes. These claims survey AS 08.68 and 12 AAC 44.400 through 44.480; they do not survey the rest of Title 12, and the PHYSICIAN ASSISTANT rules on this page are a different article with a different answer — 12 AAC 40.410 requires a collaborative plan.
AS 08.68.805 (Delegation of nursing functions) · verified Sep 5, 2026
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The Nurse Practice Act defines registered nursing as diagnosing and treating human responses, establishing a nursing diagnosis, prescribing and delegating nursing interventions, and related acts. Prescriptive authority for legend drugs is granted separately, to registered nurse practitioners, and not by this definition.
A.R.S. §32-1601(24) · verified Jul 26, 2026
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ARKANSAS DRAWS ITS LINE AT WHERE THE DRUG IS GIVEN AND HOW CLOSE THE SUPERVISOR IS. Delegated administration of drugs covers only drugs that do not require substantial, specialized judgment and skill, and is permissible only WITHIN THE PHYSICAL BOUNDARIES of the delegating physician’s offices. For a physician assistant, a supervising or back-up supervising physician should be available for IMMEDIATE TELEPHONE CONTACT any time the assistant is rendering services to the public.
17 CAR § 140-1806 (Availability of supervising physician) · verified Sep 4, 2026
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A registered nurse administering medications or therapeutic agents must be implementing a regimen ordered by, and within the scope of licensure of, a physician, dentist, podiatrist or clinical psychologist. Functions shared with other practitioners are performed under standardized procedures developed within an organized health care system.
Cal. Bus. & Prof. Code §2725 · verified Jul 26, 2026 · read at Public.Law — California Codes
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Colorado APRNs prescribe only with separate, earned authority: THREE YEARS of clinical experience, then 750 HOURS of documented prescribing mentorship. Two details matter to a med spa — remote mentoring must be SYNCHRONOUS (e-mail does not count), and a mentor MAY NOT REQUIRE PAYMENT OR EMPLOYMENT as the price of the relationship.
Colo. Rev. Stat. § 12-255-112(1)(a), (3)(a) · verified Sep 2, 2026
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Connecticut defines registered nursing as a list of functions — diagnosing human responses to actual or potential health problems, supportive and restorative care, health counseling and teaching, case finding and referral, collaborating in the implementation of the total health care regimen, and executing the medical regimen under the direction of a licensed physician, dentist or advanced practice registered nurse. An advanced practice registered nurse must collaborate with a Connecticut-licensed physician for the first three years after licensure, and the statute defines what that collaboration must address: consultation and referral, coverage in the nurse’s absence, a method to review patient outcomes, and disclosure of the relationship to the patient.
Conn. Gen. Stat. §20-87a(b)(2)(A) · verified Sep 3, 2026
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Delaware is an independent-practice state for advanced practice registered nurses, and says so inside the definition: advanced practice nursing is “licensed as an independent licensed practitioner” in a role and population focus approved by the Board of Nursing, and the APRN scope includes performing acts of advanced assessment, diagnosing, prescribing and ordering. The Nursing chapter sets who qualifies — an RN who has completed a graduate-level APRN program accredited by a national accrediting body and holds current certification by a national certifying body in the appropriate role and at least 1 population focus — and gives the Board of Nursing authority to grant, restrict, suspend or revoke practice or prescriptive authority.
24 Del. C. §1902(b) · verified Sep 3, 2026
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The District defines registered nursing broadly — the full scope of nursing services, including diagnosis and treatment of human response. It then adds a savings clause: nothing in the definition of practicing medicine is to be construed as preventing or restricting advanced practice registered nurses from performing their duties, so the breadth of the medicine definition does not read down APRN practice. Telehealth is separately defined to cover supervision as well as assessment, diagnosis and consultation.
D.C. Code §3-1201.02(17) (“Practice of registered nursing” defined) · verified Sep 3, 2026
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A registered nurse may administer medications and treatments — including injectables — as prescribed or authorized by a duly licensed practitioner. RNs are not independent prescribers.
Fla. Stat. §464.003 · verified Jul 26, 2026
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A nurse acting under a nurse protocol may administer and order drugs, but ordering under delegation is expressly not prescribing: it does not authorize the issuance of a written prescription. Ordering means selecting a drug, medical treatment, or diagnostic study through physician delegation under a nurse protocol or a physician assistant job description.
O.C.G.A. §43-34-23(a) · verified Aug 17, 2026 · read at FindLaw Codes
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THE NURSING ACT SECTIONS CITED HERE DESCRIBE EACH LEVEL OF NURSING AND GIVE THE ADVANCED PRACTICE REGISTERED NURSE A SCOPE OF ITS OWN. Registered nurse practice is the full scope of nursing guided by the chapter, the board’s rules, and board-recognized standards, and includes carrying out prescribed medical orders of a physician, an advanced practice registered nurse, or a supervised physician assistant; licensed practical nurse practice is a directed scope under the direction of a registered nurse, advanced practice registered nurse, physician, or other authorized provider. An advanced practice registered nurse’s scope includes advanced assessment, telehealth, and the diagnosis, prescription, selection, and administration of therapeutic measures including legend drugs and controlled substances within the nurse’s role and certification, supersedes the registered nurse scope, and, once the board grants prescriptive authority, includes prescribing and administering legend drugs and controlled substances and dispensing manufacturers’ prepackaged samples of over-the-counter and non-controlled legend drugs, never controlled-substance samples; only a board-licensed advanced practice registered nurse may use that title. A physician assistant’s supervising physician must review a set share of the physician assistant’s medical records within thirty days during the first year and audit a sample for at least thirty minutes each month thereafter. None of the sections cited here mentions injectables, neuromodulators, or fillers by name.
Haw. Rev. Stat. § 457-2.7(a)-(b) · verified Sep 8, 2026
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An Idaho advanced practice registered nurse is a registered nurse licensed in the state who has gained additional specialized knowledge, skills and experience through a program of study recognized or defined by the board. The statute authorizes the APRN to perform advanced nursing practice, WHICH MAY INCLUDE the prescribing, administering and dispensing of therapeutic pharmacologic agents as defined by board rules — and then bounds it twice: the APRN shall perform only those acts as provided by the board and for which the individual is educationally prepared, and the APRN collaborates with other health professionals in providing health care. Four roles are named: certified nurse-midwife, clinical nurse specialist, certified nurse practitioner and certified registered nurse anesthetist. Because the operative limits are set by BOARD RULE, the statute alone does not fix the scope of any particular procedure.
Idaho Code §54-1402(1) · verified Sep 3, 2026
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Illinois grants APRNs full practice authority on conditions, and the regulator spells out where that authority stops. It is unusually explicit about the ceiling: local anesthetic only, and no operative surgery.
225 ILCS 65/65-43 · verified Aug 17, 2026
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Registered nursing includes executing regimens delegated by a physician or other authorized prescriber. An RN does not independently prescribe; an RN administers injectables pursuant to a valid order within the delegated regimen.
Ind. Code §25-23-1-1.1 · verified Jul 26, 2026
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IOWA GIVES THE ARNP A NAMED LIST AND THE MEDICAL SPA RULE A NAMED CATEGORY. An ARNP practices to the full extent of their license, education and experience within their population foci. Inside a medical spa, a nurse falls within the rule’s category of a QUALIFIED LICENSED OR CERTIFIED NONPHYSICIAN PERSON — someone licensed by another health or skin-care board who may perform a medical aesthetic service the medical director has delegated, under that director’s supervision.
Iowa Admin. Code r. 481—621.4(4) (Advanced registered nurse practitioners — scope) · verified Sep 4, 2026
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Kansas gates the advanced practice registered nurse TITLE on board licensure: no professional nurse may announce or represent to the public that they are an advanced practice registered nurse unless they have complied with the requirements established by the board and hold a valid APRN license. The board establishes those standards and requirements, including standards and requirements relating to the education of advanced practice registered nurses. The healing arts act separately makes it unprofessional conduct to use any letters, words or terms as an affix, on stationery, in advertisements or otherwise indicating that a person is entitled to practice a branch of the healing arts for which that person is not licensed.
Kan. Stat. Ann. §65-1130(a) · verified Sep 3, 2026
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A KENTUCKY PHYSICIAN ASSISTANT MAY RENDER NO MEDICAL SERVICE AT ALL WITHOUT A SIGNED, IN-EFFECT SUPERVISION AGREEMENT, and a physician may not supervise one without board approval — failing to obtain that approval is itself unprofessional conduct. The agreement must state the scope of medical services and procedures the supervising physician approves, and the level and method of supervision. Kentucky defines advanced practice registered nursing as the performance of ADDITIONAL ACTS by registered nurses who have gained advanced clinical knowledge and skills through an accredited education program preparing them for one of the four APRN roles, who are nationally certified as a certified nurse practitioner, certified registered nurse anesthetist, certified nurse midwife or clinical nurse specialist. Those additional acts, SUBJECT TO APPROVAL OF THE BOARD, include but are not limited to prescribing treatment, drugs and devices and ordering diagnostic tests. Registered nursing practice is defined separately and includes the ADMINISTRATION OF MEDICATION AND TREATMENT AS PRESCRIBED by a physician, physician assistant, dentist, or advanced practice registered nurse, and as further authorized or limited by the board. An APRN applicant must file a written application with evidence, verified by oath, of an accredited APRN education program, national certification, English proficiency, and a passed jurisprudence examination.
Ky. Rev. Stat. §311.854(1) · verified Sep 3, 2026
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Louisiana defines the advanced practice registered nurse by NATIONAL CERTIFICATION plus board criteria: an APRN is a licensed registered nurse certified by a nationally recognized certifying body, such as the American Nurses Credentialing Center, as having an advanced nursing specialty described in the Part, and who meets the criteria for an APRN established by the board. Where no national certification examination exists in a selected clinical area, the board may establish commensurate requirements. The definition then names the roles it includes — among them the certified nurse midwife, educated in the disciplines of nursing and midwifery and authorized to manage nurse midwifery care in the antepartum, intrapartum, postpartum and gynecological periods, and the certified registered nurse anesthetist, educated in the field of nurse anesthesia and certified to the requirements of a nationally recognized certifying body. Because the operative criteria are set by the BOARD, these claims do not fix the scope of any particular procedure.
La. Rev. Stat. §37:913(1) · verified Sep 3, 2026
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MAINE IS NOT A DAY-ONE INDEPENDENT-PRACTICE STATE FOR NURSE PRACTITIONERS, AND THIS IS THE SECTION TO READ BEFORE STAFFING. A certified nurse practitioner qualifying as an advanced practice registered nurse must practice for AT LEAST 24 MONTHS under the supervision of a licensed physician or a supervising nurse practitioner, or be employed by a clinic or hospital with a medical director who is a licensed physician, and must submit written evidence to the board on completing that clinical experience. Certified nurse practitioners and certified nurse midwives may prescribe and dispense drugs or devices in accordance with board rules. Advanced practice registered nursing is defined by reference to the board’s own rulemaking on scope and standards, and expressly includes consultation with or referral to medical and other health care providers when required by client health care needs.
32 M.R.S. §2102(2-A) · verified Sep 3, 2026
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Maryland defines registered nursing to include execution of a therapeutic regimen — expressly including the administration of medication and treatment — and both independent nursing functions and delegated medical functions, which is the frame an injecting RN works inside. Separately, a certified nurse practitioner may INDEPENDENTLY diagnose common short-term and chronic stable problems, order and perform therapeutic and corrective measures, and prescribe drugs.
Md. Code Regs. 10.27.07.03(A) (Nurse Practitioner — Scope and Standards of Practice) · verified Sep 3, 2026
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MASSACHUSETTS ALREADY GRANTS NURSE PRACTITIONERS INDEPENDENT PRACTICE AUTHORITY — after not less than 2 years of supervised practice following board-recognized certification, or 2 years of alternative experience the Board accepts. ⚠️ BUT THE GRANT IS OVER PRESCRIBING, NOT PROCEDURES: it runs to issuing prescriptions and medication orders and ordering tests and therapeutics, and § 80E leaves everything else to regulations the Board is directed to promulgate. Before those 2 years, prescribing runs on mutually agreed written guidelines and every prescription names the supervisor. Nursing practice separately includes administering what an authorized prescriber has ordered, and every licensee is DIRECTLY ACCOUNTABLE for the safety of the care they personally deliver.
Mass. Gen. Laws ch. 112, § 80B · verified Sep 1, 2026
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Michigan reaches advanced practice through a SPECIALTY CERTIFICATION granted by the Board of Nursing rather than a separate license, and defines practical nursing as performed under the supervision of an RN, physician or dentist.
Mich. Comp. Laws § 333.17201 (scope of this section) · verified Sep 2, 2026 · read at Internet Archive snapshot — evidence of a page, not the current rule
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Minnesota is a FULL PRACTICE AUTHORITY state for APRNs — but only after 2,080 postgraduate hours under a collaborative agreement. Who may INJECT is answered by the drug statute rather than the medical practice act: § 151.37 lets a practitioner have a legend drug administered by a nurse under their direction. The nurse practice act then supplies the standing-order route — § 148.235 subd. 8 lets an RN work to a PROTOCOL WITHOUT REFERENCE TO A SPECIFIC PATIENT. Both chapters are load-bearing.
Minn. Stat. § 151.37, subd. 2(a) · verified Sep 2, 2026
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THE NURSING SECTIONS CITED HERE DEFINE EACH LEVEL OF NURSING BY THE ORDER IT FOLLOWS AND TIE THE ADVANCED PRACTICE REGISTERED NURSE TO A COLLABORATING PHYSICIAN. Registered-nurse practice includes executing the medical regimen, including administering medications and treatments prescribed by a licensed physician or dentist, and excludes medical diagnosis and prescribing except as the Board of Nursing provides by rule; licensed practical nursing is performed under the direction of a registered nurse, physician, or dentist using standardized procedures. An advanced practice registered nurse may diagnose, treat, and manage medical conditions and may hold prescriptive authority, but must practice in a collaborative/consultative relationship with a physician or dentist holding an unrestricted Mississippi license, within a board-approved protocol filed with the board, and may not practice as an APRN without that relationship and protocol; the Board of Nursing requires reliable communication with the collaborating physician and a formal collaborative agreement submitted before practice, and lets an authorized APRN prescribe Schedules II through V. Nurse practitioners may engage in that nursing practice without a physician’s license. The medical board files each collaboration and reviews protocols for practices more than seventy-five miles from the physician. Physician assistants are licensed and regulated by the medical board and supervised by a physician who practices in Mississippi at least twenty hours a week and is approved to supervise. None of the sections cited here mentions injectables, neuromodulators, or fillers by name.
Miss. Code Ann. § 73-15-5(2) · verified Sep 8, 2026
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An advanced practice registered nurse in Missouri is a person licensed under the nursing chapter to practice advanced practice nursing as a certified clinical nurse specialist, certified nurse midwife, certified nurse practitioner or certified registered nurse anesthetist. PRESCRIBING RUNS THROUGH THE WRITTEN ARRANGEMENT ON THE FACE OF THESE CLAIMS: a collaborative practice arrangement MAY delegate to an APRN the authority to administer, dispense or prescribe drugs and provide treatment, and may delegate authority over controlled substances in Schedules III, IV and V and Schedule II hydrocodone. The delegation runs through the written arrangement described in the supervision section of this reference; whether any independent route exists elsewhere in the nursing chapter is not surveyed by these claims. PHYSICIAN ASSISTANTS are bounded differently again: the statute enumerates their scope of practice as consisting ONLY of nine listed services and procedures, and says a physician assistant may not prescribe any drug, medicine, device or therapy except pursuant to a collaborative practice arrangement.
Mo. Rev. Stat. §335.016(2) · verified Sep 3, 2026
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THE NURSING ACT SECTIONS CITED HERE DEFINE THE PRACTICE BY THE ORDER IT FOLLOWS, NOT BY PROCEDURE. Professional nursing includes the administration of medications and treatments prescribed by physicians, physician assistants, advanced practice registered nurses, and the other prescribers the statute lists, and practical nursing is the same administration under the supervision of a registered nurse or a prescriber; the chapter confers no authority to practice medicine. An APRN is a registered nurse who has completed the board-specified education for a role, practices on board approval of a certificate in that role, and, under the Board of Nursing’s rules, practices independently and/or collaboratively, including establishing medical diagnoses and treating patients, and prescribes legend and controlled substances only after the Board grants prescriptive authority. Certified nurse practitioner practice is defined as independent and/or collaborative management of primary or acute care. Performing procedures beyond the authorized scope, delegating contrary to the nursing laws, and failing to supervise are unprofessional conduct for a nurse. A physician assistant must be licensed by the Board of Medical Examiners and practice within the PA’s competency; a PA with fewer than 8,000 hours of postgraduate clinical experience commits unprofessional conduct by practicing without a collaborative agreement, and chart review frequency is set at the practice level in that agreement. None of the sections cited here mentions injectables, neuromodulators, or fillers by name.
Mont. Admin. R. 24.159.1406(1) · verified Sep 8, 2026
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Nebraska defines registered nursing as assuming responsibility and accountability for nursing actions — assessing human responses to actual or potential health conditions, establishing nursing diagnoses, establishing goals and outcomes, establishing and maintaining a plan of care, prescribing nursing interventions and implementing that plan. A nurse practitioner license additionally requires a graduate-level program in the nurse practitioner clinical specialty accredited by a NATIONAL ACCREDITING BODY, proof of passing an examination pertaining to the specific nurse practitioner role, and evidence of two thousand hours of practice as a nurse practitioner.
Neb. Rev. Stat. §38-2212(1), (2) · verified Sep 3, 2026
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Nevada’s Nurse Practice Act grants an advanced practice registered nurse authority to engage in selected medical diagnosis and treatment and, where separately authorized, to prescribe — bounded by the rule that an APRN may not undertake anything he or she is not qualified to perform. Registered nurses, APRNs and physician assistants are each named on the statutory list of those who may inject dermal or soft tissue fillers, subject to their own scope of practice and to the location requirement.
Nev. Rev. Stat. §632.237(2) · verified Sep 3, 2026
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An advanced practice registered nurse in New Hampshire is a registered nurse currently licensed by the board under RSA 326-B:18, and the statute defines the APRN-patient relationship in medical terms: an in-person or telemedicine exam, a history, a diagnosis, a treatment plan appropriate to the licensee’s specialty, and documentation of every prescription drug by name and dosage.
N.H. Rev. Stat. §326-B:2, I · verified Sep 3, 2026
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The delegation rule names the licensed people a physician may direct — physical therapists, registered and practical nurses, physician assistants, chiropractors, athletic trainers and occupational therapists — and treats them as a different category from the unlicensed aide. The examination, qualification and supervision duties are undiminished: delegating to a licensed person relaxes none of them.
N.J.A.C. 13:35-6.14(a) · verified Aug 17, 2026 · read at Cornell Legal Information Institute
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NEW MEXICO TIERS THE NURSING LICENSES EXPLICITLY FOR THIS SETTING. An APRN with the appropriate population foci, licensure, national certification and education may perform aesthetic healthcare procedures and is the only nursing license that may serve as a CLINICAL SUPERVISOR. An RN may perform them with appropriate education and training only if DELEGATED BY and under the INDIRECT supervision of an APRN or other clinical supervisor. An LPN may perform them only under DIRECT supervision — the supervisor physically in the facility — and MAY NOT PERFORM AESTHETIC INJECTIONS at all. An RN or LPN may not serve as a clinical supervisor.
16.12.14.8(D) NMAC (Education and scope of practice) · verified Sep 4, 2026
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Registered professional nursing includes executing medical regimens prescribed by a licensed physician, dentist or other authorized provider. A nursing regimen must be consistent with, and may not vary, an existing medical regimen — so a registered nurse administers an injectable pursuant to an order rather than on their own judgment.
N.Y. Educ. Law §6902(1) · verified Aug 17, 2026
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North Carolina answers the injector question directly rather than by inference. Chemical peels, sclerotherapy, micropigmentation, light treatments, microdermabrasion, laser hair removal and neuromodulator and dermal filler injections are all inside a licensed nurse’s scope — on conditions.
NC Board of Nursing, Cosmetic/Aesthetic Dermatological Procedures Position Statement (rev. 9/2022) · verified Aug 17, 2026
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The Nurse Practices Act defines an advanced practice registered nurse as one licensed in the state within one of four roles — certified nurse practitioner, certified registered nurse anesthetist, certified nurse midwife or certified clinical nurse specialist — and functioning in a population focus the board approves. On delegation, § 43-12.1-16 provides that a licensed nurse MAY delegate MEDICATION ADMINISTRATION to a person the chapter exempts under two named subsections. These claims establish the APRN definition and the delegation limit; they do not establish whether an APRN may practice without physician collaboration.
N.D.C.C. § 43-12.1-02 (Definition of advanced practice registered nurse) · verified Sep 5, 2026
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Ohio is a collaboration state for nurse practitioners — a CNP practices in collaboration with one or more physicians, not independently — and the laser rule then treats nurses as delegatees rather than autonomous operators.
Ohio Rev. Code §4723.43(B) · verified Aug 17, 2026
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OKLAHOMA GRANTS INDEPENDENT PRESCRIPTIVE AUTHORITY, AND IT IS EARNED IN HOURS. § 567.4c opens it to an APRN recognized as a Certified Nurse Practitioner, Clinical Nurse Specialist or Certified Nurse-Midwife who has completed a MINIMUM OF 6,240 CLINICAL PRACTICE HOURS with prescriptive authority. Prescribing remains formulary-bounded either way: the Board maintains an EXCLUSIONARY formulary listing drugs and categories an APRN may not prescribe, and its Formulary Advisory Council also recommends practice-specific prescriptive standards for each category of APRN. These claims establish the hours threshold, the exclusionary formulary and that recommendation duty; they do not establish which drugs the current formulary excludes.
Okla. Stat. tit. 59, § 567.4c(A) (Independent prescriptive authority for APRNs) · verified Sep 5, 2026
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Oregon defines the practice of nursing as AUTONOMOUS AND COLLABORATIVE care, and includes within it executing medical orders prescribed by a physician or other authorized provider. Nurse practitioners are licensed by the Board of Nursing and the title is reserved; prescribing authority is separate, requiring approval under ORS 678.390 and bounded by the scope of practice the board defines by rule.
Or. Rev. Stat. §678.010(9) (“Practice of nursing” defined) · verified Sep 3, 2026
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Pennsylvania is a collaborative-agreement state for nurse practitioners, and it is prescriptive about the paperwork: the agreement must name a substitute physician for when the collaborating one is unavailable.
49 Pa. Code §21.283(a) · verified Aug 17, 2026 · read at Cornell Legal Information Institute
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Rhode Island writes APRN autonomy into the definition itself. “Advanced practice registered nursing” means an INDEPENDENT AND EXPANDED scope of nursing, in a role and population focus approved by the board of nurse registration and nursing education, that includes the registered nurse scope of practice and may include performing acts of advanced assessment, diagnosing, prescribing and ordering. The APRN title covers the certified nurse practitioner, the certified registered nurse anesthetist and the certified clinical nurse specialist, each functioning in a population focus, and an APRN MAY SERVE AS A PRIMARY- OR ACUTE-CARE PROVIDER OF RECORD. The same definition attaches the accountability: each APRN is accountable to patients, the profession and the board for complying with the chapter and for the quality of care rendered, for recognizing the limits of their knowledge and experience, for planning for situations beyond their expertise, and for consulting with or referring patients to other healthcare providers as appropriate. PHYSICIAN ASSISTANTS are on a different footing: they shall practice IN COLLABORATION WITH PHYSICIANS, and within that may provide any medical or surgical services within their own skills, education and training, including prescribing, administering, procuring and dispensing drugs and medical devices.
R.I. Gen. Laws §5-34-3(2) · verified Sep 3, 2026
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An advanced practice registered nurse in South Carolina may perform specified medical acts only pursuant to a written PRACTICE AGREEMENT with a physician or medical staff — the agreement must establish the medical aspects of care to be provided, including prescribing, and must contain mechanisms letting the physician ensure clinical quality and patient safety. The medical acts a nurse may perform are agreed jointly by the Board of Nursing and the Board of Medical Examiners.
S.C. Code §40-33-20(45) (“Practice agreement” defined) · verified Sep 3, 2026
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South Dakota enumerates the certified nurse practitioner scope as a list of powers ADDED to the registered nurse scope. Within the CNP role and population focus, a certified nurse practitioner may conduct an advanced assessment; order and interpret diagnostic procedures; ESTABLISH PRIMARY AND DIFFERENTIAL DIAGNOSES; and prescribe, order, administer and furnish therapeutic measures — including diagnosing, prescribing and instituting therapy or referrals, and prescribing, procuring, administering and furnishing pharmacological agents, over-the-counter, legend and controlled drugs listed on Schedule II included. The same subsection extends to planning and initiating a therapeutic regimen that includes ordering and prescribing NONPHARMACOLOGICAL INTERVENTIONS, naming durable medical equipment and medical devices among them. PHYSICIAN ASSISTANTS are scoped by capability on the face of these claims: a PA may provide the enumerated medical and surgical services FOR WHICH THE PA HAS BEEN PREPARED by education, training and experience and is competent to perform — and among the licensure criteria on record is that the board MAY grant a license to an applicant who has either filed an affidavit attesting to at least SIX THOUSAND PRACTICE HOURS or entered into a collaborative agreement.
S.D. Codified Laws §36-9A-12 · verified Sep 3, 2026
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WHERE a physician supervises a Tennessee certified nurse practitioner who writes prescriptions, that physician must hold an UNENCUMBERED license — the same standard the Board of Medical Examiners applies to physician assistants, and set out in that board’s own rules.
Tenn. Comp. R. & Regs. 0880-02-.14(12), referring to 0880-02-.18(1) and 0880-06-.02(1) · verified Sep 2, 2026
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A registered nurse who is not an APRN (and an LVN) may not perform medical diagnosis or prescribe, but may carry out a delegated medical act — such as administering a cosmetic injection ordered by an appropriately licensed practitioner — when the Board of Nursing’s criteria are met: documented competency/education, written policies and guidelines, an order from an appropriate licensed practitioner, and available medical and nursing support.
Tex. BON Position Statement 15.11 · verified Jul 26, 2026
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UTAH ROUTES PRESCRIBING THROUGH THE LICENSE. Issuing a prescription for a prescription drug as an RN or LPN is listed as unprofessional conduct except under Section 58-17b, the section the rule itself names. The nursing rules name who may direct the tasks of a licensed practical nurse — an advanced practice registered nurse, a certified nurse midwife, a physician assistant, and other named practitioners —. On the medical side, the licensure-exemption rule for medical assistants places the injection of a neurotoxin or filler for cosmetic purposes outside what that exemption covers.
Utah Admin. Code R156-31b-502(1)(c) (Unprofessional conduct) · verified Sep 4, 2026
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Vermont runs a transition-to-practice scheme rather than immediate independence. An APRN is licensed to perform acts of MEDICAL DIAGNOSIS and to prescribe medical, therapeutic or corrective measures; but an APRN with fewer than 24 months and 2,400 hours of licensed active advanced nursing practice must hold a formal collaborative provider agreement and MAY NOT engage in solo practice until those requirements are met.
Vt. Stat. tit. 26, §1613(a)(1) (Transition to practice) · verified Sep 3, 2026
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A Virginia nurse practitioner can reach AUTONOMOUS PRACTICE, but only by meeting a statutory experience threshold; until then a written practice agreement with a named patient care team physician is mandatory.
Va. Code § 54.1-2957(B) · verified Sep 2, 2026
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Registered nursing in Washington expressly includes executing a medical regimen prescribed by a physician, physician assistant or ARNP — and separately includes delegation. An ARNP’s expanded role is defined by the nursing board rather than by statute.
Wash. Rev. Code 18.79.050 · verified Sep 2, 2026
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PRESCRIBING IS THE HINGE IN WEST VIRGINIA, AND IT IS NOT AUTOMATIC. The Board of Examiners for Registered Professional Nurses issues the advanced practice registered nurse license to an applicant nationally certified in one of four recognized roles, and an APRN is by virtue of that license also licensed as a registered professional nurse. PRESCRIPTIVE AUTHORITY is separate: an APRN becomes eligible to apply only after completing 45 contact hours of education in pharmacology and clinical management of drug therapy under a board-approved program, 15 of them within the two years immediately before entering a prerequisite COLLABORATIVE RELATIONSHIP — and the board authorizes prescribing under the terms of a collaborative agreement, on being satisfied the collaborating physician is licensed in good standing. These claims survey the licensure and prescriptive-authority sections of the nursing article.
W. Va. Code §30-7-15b(a)(3) · verified Sep 3, 2026
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Wisconsin’s medical board governs the physician’s side of a delegation; the nurse’s own scope sits with the Board of Nursing, and this corpus has not read that chapter.
Wis. Admin. Code Med §§ 10.02(1) and 10.03(1)(L) · verified Sep 2, 2026
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Wyoming writes prescribing authority into the DEFINITION of the advanced practice registered nurse. An APRN is a nurse who MAY PRESCRIBE, ADMINISTER, DISPENSE OR PROVIDE nonprescriptive and prescriptive medications, including prepackaged medications, except Schedule I drugs; who has responsibility for the direct care and management of patients and clients in relation to their human needs, disease states and therapeutic and technological interventions; who holds a doctorate or master's degree in nursing or an APRN specialty, or completed an accredited APRN educational program before January 1, 1999; and who has completed an advanced program of study in a specialty area, passed a national certification examination in that same area, and been granted licensure by the board to practice as an APRN. The authority and the qualifications are stated together in one definition, so each element is a condition of the role. PHYSICIAN ASSISTANTS are described differently again: the statute says a physician assistant IS AN INDIVIDUAL WHO PRACTICES MEDICINE, qualified by education, training and experience to provide a broad range of diagnostic, therapeutic and preventive services, who may collaborate with or refer to the appropriate member of a healthcare team — and it puts the DEGREE OF COLLABORATION at the practice level, which may include decisions made by the employer, group, hospital service or the credentialing and privileging systems.
Wyo. Stat. Ann. §33-21-120(a)(i)(A) · verified Sep 3, 2026
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