What must the supervising physician actually do, state by state
The same question, answered for 34 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 20, 2026.
Oversight · part of The Practice Perimeter
| State | What its rule says | Cited to |
|---|---|---|
| Alabama | At minimum, keep a written protocol on site naming the physician, with proof of his training and the delegate's activities, decision criteria and plan — plus supervise each delegated treatment on-site or locally remote and personally treat complications. | Ala. Admin. Code r. 540-X-11-.05 (Written protocols) Sep 4, 2026 |
| Alaska | written instructions that include (A) a clear description of the procedure to follow to perform each task in the delegated duty; (B) the predicted outcomes of the delegated task; (C) procedures for observing, reporting, and responding to side effects, complications, or unexpected outcomes in the patient; and (D)… | 12 AAC 40.920(a)(7) (Written instructions for a delegated duty) Sep 5, 2026 |
| Arizona | For injections by a medical assistant, a physician, PA or nurse practitioner must be in the same room or office suite; being reachable by phone isn't enough. Failing to supervise assistants is unprofessional conduct. | A.R.S. §32-1456(A) and (D) Sep 1, 2026 |
| Arkansas | (2) The physician, when delegating these minor procedures, must comply with the following protocol: | 17 CAR § 140-1601(b)(2) (Laser surgery guidelines — protocol) Sep 4, 2026 |
| California | Be immediately available — a physician with relevant laser/IPL training must be reachable by phone or electronically without delay, interruptible, and able to give assistance and direction throughout and cover post-procedure care, per the written protocols. | Cal. Code Regs. tit. 16, §1364.50 Sep 1, 2026 |
| Connecticut | For a physician assistant: set the terms of a written delegation agreement covering the professional relationship, the services the PA may perform, controlled-substance documentation and how the PA's performance is evaluated, and review it at least annually. | Conn. Gen. Stat. §20-12d(a) Sep 8, 2026 |
| Delaware | Stay responsible and involved, not in name only: be on site and personally evaluate or consult whenever a diagnosis is made or a prescription treatment plan is started; otherwise be on site or reachable and able to arrive within 30 minutes. | 24 DAC 1700 §§11.1.1, 11.1.3, 11.1.4, 11.1.7 (Delegation of responsibilities to non-physicians) Sep 8, 2026 |
| District of Columbia | The cited rules do not settle this — they require only that a medical assistant work under the direct supervision of a physician, PA, or APRN and bar subcutaneous procedures other than vaccines or injections; "direct supervision" is left undefined. | D.C. Code §3-1201.02(6D) Sep 8, 2026 |
| Florida | If an NP or PA works without on-site supervision in a skin-care office away from the physician's main practice, the physician must be a board-certified or board-eligible dermatologist or plastic surgeon and may supervise only one such office. | Fla. Stat. §458.348(3)(c)2. Sep 1, 2026 |
| Georgia | Set and file the facility's laser protocols with the Board, be trained in laser modalities, and stay available for emergency consultation — and be Georgia licensed with a principal place of business in state or practice within 50 miles of the facility. | Ga. Comp. R. & Regs. 360-35-.06 Aug 17, 2026 |
| Hawaii | Delegate, oversee continuously, and answer for the work — the PA may perform only duties the supervising physician delegates, and that physician must direct and exercise supervision at all times; continuous supervision is not necessarily on-site. | Haw. Admin. R. § 16-85-44.5 (Definitions — “Supervising physician”; “Supervision”) Sep 8, 2026 |
| Illinois | In an office or practice setting and within a physician-patient relationship, a physician may delegate patient care tasks to an unlicensed person who has appropriate training and experience, provided a health care professional is on site to provide assistance. | 225 ILCS 60/54.2(b), (f) Aug 17, 2026 |
| Iowa | Concrete duties — the medical director must develop and implement emergency-response protocols for delegated services, do on-site review each week, review at least 10% of charts, and ensure each staffer gets four hours of in-person supervision weekly. | Iowa Admin. Code r. 481—655.6(5)(h) (Supervision — emergency protocols) Sep 4, 2026 |
| Kansas | Not a checklist — the cited rules impose a duty: properly supervise, direct and delegate healing-arts acts performed under the physician's order, referral, delegation or protocols, and delegate only to persons qualified by training, experience or licensure. | Kan. Stat. Ann. §65-2837(a)(30) Sep 8, 2026 |
| Kentucky | Kentucky's esthetic practices regulation provides that “Dermaplane procedures, dermabrasion procedures, microneedling procedures, blades, knives, and lancets are prohibited, except for: (a) Procedures for basic exfoliation; (b) Advanced extraction of impurities from the skin using a lancet of 2mm or less; and (c)… | 201 KAR 12:280, Section 3(2) Sep 20, 2026 |
| Maryland | Evaluate the risk and outcome, delegate only customary acts the assistant is trained for, supervise, and stay responsible; nonsurgical acts may be delegated under direct or on-site supervision done per site procedures, and some tiers need no on-site presence. | Md. Code Regs. 10.32.12.04(B)(2) Sep 3, 2026 |
| Massachusetts | Not on-site — supervision of a physician assistant must be continuous but never requires the physician's personal presence; the supervisor sets the PA's scope from their training and experience and stays legally responsible for an employed PA at all times. | Mass. Gen. Laws ch. 112, § 9E Sep 1, 2026 |
| Michigan | Three things, for laser procedures: stay continuously reachable in person or by phone/telecom, be available on a regular schedule to review the delegate's work, consult, review records and educate, and set predetermined procedures and drug protocols. | Mich. Comp. Laws § 333.16276(5)(c) (“Supervision” defined for laser procedures) Sep 8, 2026 |
| Mississippi | Oversee the PA's activities and accept responsibility for all medical services rendered — supervision must be continuous but need not be in person, except new graduate or first-licensed PAs need an on-site supervising physician for 120 days (960 hours). | Miss. Admin. Code Title 30, Part 2615, Rule 1.6 (Supervision) Sep 8, 2026 |
| Missouri | A physician may enter into collaborative practice arrangements with registered professional nurses. | Mo. Rev. Stat. §334.104.1 Sep 3, 2026 |
| Montana | For a medical assistant: chart the MA and tasks, and ensure by oversight it meets your standard of care. Personal onsite or direct supervision for invasive procedures, IV meds, sedation monitoring, allergy testing, and injections other than immunizations. | Mont. Admin. R. 24.156.401(3) Sep 8, 2026 |
| New Jersey | The doctor must set every element of that session's treatment — modality, extent of area treated, length, and any modality-specific risk such as body parts to avoid — as a written order on the patient's chart, available at all times to the assistant. | N.J.A.C. 13:35-6.14(e)2 Aug 17, 2026 |
| New Mexico | Write and own the protocols — the clinical supervisor (an APRN or other licensed independent practitioner) must develop or approve and implement written protocols for every procedure the facility offers, including how to identify and respond to adverse events. | 16.12.14.9(B)(5) NMAC (Clinical supervisor) Sep 4, 2026 |
| New York | Give the order and stay reachable — energy-device treatments that are the practice of medicine must be performed by or under the order of a physician, PA, or NP, who need not be on site but must be available to guide or intervene within a reasonable period. | N.Y. State Board for Medicine — Use of Energy Devices Including Lasers as the Practice of Medicine (Mar. 7, 2025) Aug 17, 2026 |
| North Carolina | Among other duties — for laser hair or tattoo removal, ensure each patient is examined by a physician, PA, or NP before the first treatment and as medically indicated, and that any medication given with it comes with thorough safe-use instructions. | NCMB Position Statement 5.1.2 (Laser surgery — supervision and written protocols) Sep 8, 2026 |
| Ohio | Before a nurse applies a vascular laser, the physician must confirm eight hours of light-based education, fifteen observed procedures of that type, and twenty performed with the physician in the room — then supervise on site at all times. | Ohio Admin. Code 4731-18-03(A)(7) Sep 1, 2026 |
| Oklahoma | The physician must provide appropriate methods of supervising the PA's services — including formulating or approving all orders and protocols directing the PA's care and periodically reviewing them. The statute's list is "including," not a closed set. | Okla. Stat. tit. 59, § 519.6(a) (Responsibility for all orders and protocols) Sep 5, 2026 |
| Pennsylvania | Before each delegated service the physician must verify the staffer's training and competency, judge that this patient faces no undue risk, explain the delegation to the patient, and take responsibility — and may never delegate what they can't do themselves. | 49 Pa. Code §18.402 Aug 17, 2026 |
| South Carolina | The physician must set the delegated acts in approved written scope-of-practice guidelines or protocols and stay readily or immediately available for consultation — and for unlicensed personnel, "immediately available" means physically in the office. | S.C. Code §40-47-20(12), (18) Sep 8, 2026 |
| Tennessee | For a physician assistant — jointly develop and approve protocols with the PA that cover the applicable standard of care, review and update them biennially, and keep them at the practice site. | Tenn. Comp. R. & Regs. 0880-02-.18(5) Sep 2, 2026 |
| Texas | Review, approve, or develop a written order naming the physician, setting patient-screening criteria, describing appropriate care, and covering common complications; a physician, PA, or APRN must be onsite or immediately available during it. | 22 TAC §169.27 Jul 26, 2026 |
| Utah | For microneedling by a master esthetician deeper than 1.5 mm, the supervising practitioner must authorize the procedure, stay within 60 minutes or 60 miles, and be able to come in person to treat a complication; at 1.5 mm or less, none is required. | Utah Admin. Code R156-11a-611(5) (Standards for Approval of Mechanical or Electrical Apparatus) Sep 3, 2026 |
| Washington | Delegate LLRP treatment only against a written office protocol covering seven points: the authorizing physician; the delegate's activities, criteria and plan; patient selection; devices and settings; device operation, upkeep; complication care; documentation. | Wash. Admin. Code 246-919-605(10)(d) Sep 2, 2026 |
| Wisconsin | Delegated medical procedures shall be undertaken only pursuant to formal written protocols setting forth the nature and scope of the procedures delegated, describing the supervisory plan, and indicating any contraindications to undertaking the procedure; a laser hair removal product or device, or intense pulsed… | Wis. Admin. Code § Cos 2.025(3)–(4) Sep 8, 2026 |
Every state, in its own words
Alabama
Written protocols for the purpose of this section shall mean physician’s order, standing delegation order, standing medical order, or other written order that is maintained on site. A written protocol must be provided to the Board upon request and must provide, at a minimum, the following: (1) A statement identifying the individual physician authorized to utilize the specified device and responsible for the delegation of the performance of the specified procedure, including proof of the physician’s training in accordance with these rules; (2) A statement of the activities, decision criteria, and plan the Level 1 or 2 Delegate shall follow when performing delegated procedures;
Ala. Admin. Code r. 540-X-11-.05 (Written protocols) · verified Sep 4, 2026
The full Alabama answer, with the rest of the section → · Every Alabama rule on physician supervision & delegation →Alaska
written instructions that include (A) a clear description of the procedure to follow to perform each task in the delegated duty; (B) the predicted outcomes of the delegated task; (C) procedures for observing, reporting, and responding to side effects, complications, or unexpected outcomes in the patient; and (D) the procedure to document the performance of the duty in the patient's record.
12 AAC 40.920(a)(7) (Written instructions for a delegated duty) · verified Sep 5, 2026
The full Alaska answer, with the rest of the section → · Every Alaska rule on physician supervision & delegation →Arizona
A medical assistant may take body fluid specimens and administer injections only under the direct supervision of a doctor of medicine, physician assistant or nurse practitioner. Arizona lists separately the tasks a medical assistant may do WITHOUT direct supervision — billing, coding, insurance, scheduling, charting, visual acuity screening — and injections are not among them.
A.R.S. §32-1456(A) and (D) · verified Sep 1, 2026
The full Arizona answer, with the rest of the section → · Every Arizona rule on physician supervision & delegation →Arkansas
(2) The physician, when delegating these minor procedures, must comply with the following protocol:
17 CAR § 140-1601(b)(2) (Laser surgery guidelines — protocol) · verified Sep 4, 2026
The full Arkansas answer, with the rest of the section → · Every Arkansas rule on physician supervision & delegation →California
Whenever an elective cosmetic procedure involving a laser or intense pulse light device is performed by a licensed health care provider acting within the scope of their license, a physician with relevant training and expertise shall be immediately available — defined in the rule as contactable by electronic or telephonic means without delay, interruptible, and able to furnish assistance and direction throughout the procedure and to inform the patient of post-procedure care provisions. Those provisions must sit in the provider’s standardized procedures or protocols.
Cal. Code Regs. tit. 16, §1364.50 · verified Sep 1, 2026 · read at Cornell Legal Information Institute
The full California answer, with the rest of the section → · Every California rule on physician supervision & delegation →Connecticut
Delegated functions shall be implemented in accordance with a written delegation agreement between the supervising physician and the physician assistant; the supervising physician shall establish the terms of the agreement, which must include a description of the professional relationship, identification of the medical services the physician assistant may perform, a description of how the physician assistant's prescribing of controlled substances is documented in the medical record, and a description of the process by which the supervising physician evaluates the physician assistant's performance; and the supervising physician shall review the written delegation agreement not less than annually.
Conn. Gen. Stat. §20-12d(a) · verified Sep 8, 2026
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Any physician who delegates medical responsibility to a non-physician is responsible for that individual's medical activities and must provide adequate supervision; no function may be delegated to a non-physician who by statute or professional regulation is prohibited from performing it, and the delegating physician cannot be involved in patient care in name only. Direct supervision requires the delegating physician to be physically on the premises and to perform an evaluation or give a consultation, and is required if a medical diagnosis is rendered or a treatment plan involving prescription medications is to be instituted. Indirect supervision requires the physician to be either physically present on the premises or readily available by an electronic device, meaning able to become physically present within 30 minutes of notification if the situation warrants. A supervising physician who fails to adhere to these regulations is considered to be permitting the unauthorized practice of medicine and is subject to discipline.
24 DAC 1700 §§11.1.1, 11.1.3, 11.1.4, 11.1.7 (Delegation of responsibilities to non-physicians) · verified Sep 8, 2026
The full Delaware answer, with the rest of the section → · Every Delaware rule on physician supervision & delegation →District of Columbia
The practice of medical assistants occurs only under the direct supervision of a physician, physician assistant, or advance practice registered nurse.
D.C. Code §3-1201.02(6D) · verified Sep 8, 2026
The full District of Columbia answer, with the rest of the section → · Every District of Columbia rule on physician supervision & delegation →Florida
⚠️ THE SUPERVISING PHYSICIAN MUST BE A DERMATOLOGIST OR PLASTIC SURGEON. Where the office is not the physician’s primary practice location, the nurse or assistant is not under onsite supervision, and the services are primarily dermatologic or aesthetic skin care other than plastic surgery, the physician must be board certified or board eligible in dermatology or plastic surgery as recognized by the Board under §458.3312. This is a qualification on the person, not a paperwork step, and no protocol cures its absence.
Fla. Stat. §458.348(3)(c)2. · verified Sep 1, 2026
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A consulting physician must be licensed in Georgia, have a principal place of business in Georgia or practice within 50 miles of the facility supervised, be trained in laser modalities (physics, safety, technique, indications, pre- and post-operative care, and treating complications), and be available for emergency consultation. The consulting physician establishes the protocols for the cosmetic laser services provided at a facility and files those protocols with the Board.
Ga. Comp. R. & Regs. 360-35-.06 · verified Aug 17, 2026
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A physician assistant may perform those duties and responsibilities delegated by the physician assistant's supervising physician; the supervising physician accepts responsibility for the supervision of services rendered by physician assistants and shall direct and exercise supervision at all times; and supervision, which means overseeing the activities of and accepting responsibility for the medical services rendered by a physician assistant, is continuous: supervision shall be continuous but shall not be construed as necessarily requiring the physical presence of the supervising physician at the time and place the services are rendered.
Haw. Admin. R. § 16-85-44.5 (Definitions — “Supervising physician”; “Supervision”) · verified Sep 8, 2026
The full Hawaii answer, with the rest of the section → · Every Hawaii rule on physician supervision & delegation →Illinois
In an office or practice setting and within a physician-patient relationship, a physician may delegate patient care tasks to an unlicensed person who has appropriate training and experience, provided a health care professional is on site to provide assistance. Delegation may be by oral, written or electronic means, by standing orders, protocols, guidelines or verbal orders.
225 ILCS 60/54.2(b), (f) · verified Aug 17, 2026
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Develop and implement protocols for responding to emergencies or other injuries suffered by persons receiving delegated medical aesthetic services performed by qualified licensed or certified nonphysician persons or qualified laser technicians;
Iowa Admin. Code r. 481—655.6(5)(h) (Supervision — emergency protocols) · verified Sep 4, 2026
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Failing to properly supervise, direct or delegate acts that constitute the healing arts to persons who perform professional services pursuant to the licensee's direction, supervision, order, referral, delegation or practice protocols is grounds for the board to discipline a licensee.
Kan. Stat. Ann. §65-2837(a)(30) · verified Sep 8, 2026
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Kentucky's esthetic practices regulation provides that “Dermaplane procedures, dermabrasion procedures, microneedling procedures, blades, knives, and lancets are prohibited, except for: (a) Procedures for basic exfoliation; (b) Advanced extraction of impurities from the skin using a lancet of 2mm or less; and (c) Dermaplane procedures for advanced exfoliation under direct supervision of a licensed physician.” Microneedling is not among the listed exceptions, so it is prohibited for licensees of the board under this section.
201 KAR 12:280, Section 3(2) · verified Sep 20, 2026
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A licensed physician may delegate nonsurgical technical acts while the assistant is under the licensed physician’s direct supervision or on-site supervision if the assistant performs the act in accordance with procedures of the site.
Md. Code Regs. 10.32.12.04(B)(2) · verified Sep 3, 2026
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A physician assistant may perform medical services when those services are rendered under the supervision of a registered physician. That supervision shall be CONTINUOUS but shall NOT require the personal presence of the supervising physician or physicians. Massachusetts settles the on-site question in the statute itself rather than leaving it to a board rule.
Mass. Gen. Laws ch. 112, § 9E · verified Sep 1, 2026
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Supervision, for the purposes of the section, means the overseeing of or participation in the work of another individual by a health professional licensed under the article where all of the following exist: the continuous availability of direct communication in person or by radio, telephone, or telecommunication between the supervised individual and a licensed health professional; the availability of a licensed health professional on a regularly scheduled basis to review the practice of the supervised individual, to provide consultation, to review records, and to further educate the supervised individual in the performance of the individual's functions; and the provision by the licensed supervising health professional of predetermined procedures and drug protocol.
Mich. Comp. Laws § 333.16276(5)(c) (“Supervision” defined for laser procedures) · verified Sep 8, 2026 · read at Internet Archive snapshot — evidence of a page, not the current rule
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Supervision means overseeing activities of, and accepting responsibility for, all medical services rendered by the physician assistant; except for new graduates, supervision must be continuous but shall not be construed as necessarily requiring the physical presence of the supervising physician; and new graduate physician assistants, and all physician assistants whose Mississippi license is their initial license, require the on-site presence of a supervising physician for one hundred twenty days or its equivalent of 960 hours.
Miss. Admin. Code Title 30, Part 2615, Rule 1.6 (Supervision) · verified Sep 8, 2026
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A physician may enter into collaborative practice arrangements with registered professional nurses. Collaborative practice arrangements shall be in the form of written agreements, jointly agreed-upon protocols, or standing orders for the delivery of health care services. Collaborative practice arrangements, which shall be in writing, may delegate to a registered professional nurse the authority to administer or dispense drugs and provide treatment as long as the delivery of such health care services is within the scope of practice of the registered professional nurse and is consistent with that nurse's skill, training and competence.
Mo. Rev. Stat. §334.104.1 · verified Sep 3, 2026
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A health care provider delegating administrative and/or clinical tasks to a medical assistant shall: (a) require that the medical assistant record in the patient's medical records: (i) the identity of the medical assistant to whom the health care provider has delegated tasks included in the patient's care; and (ii) the clinical tasks delegated to the medical assistant; (b) ensure through oversight and supervision that the medical assistant's performance of the delegated tasks meets the standard of medical care owed by the delegating health care provider to the patient; (c) personally provide onsite or direct supervision as defined by ARM 24.156.403 to a medical assistant to whom the health care provider has delegated: (i) injections other than immunizations; (ii) invasive procedures; (iii) conscious sedation monitoring; (iv) allergy testing; (v) intravenous administration of blood products; or (vi) intravenous administration of medication;
Mont. Admin. R. 24.156.401(3) · verified Sep 8, 2026
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The doctor must determine every component of the precise treatment for the present session — the modality, the extent of the area treated, the length of treatment and any factor peculiar to that modality’s risks, such as strict avoidance of certain parts of the body. That must be set down as a written order on the patient’s chart and be available at all times to the assistant carrying it out.
N.J.A.C. 13:35-6.14(e)2 · verified Aug 17, 2026 · read at Cornell Legal Information Institute
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develops or approves and implements written protocols for all aesthetic healthcare procedures performed at the aesthetic healthcare facility. The protocols must provide sufficient and specific details, including guidance on identifying and responding to adverse events, to assure that making independent healthcare decisions does not become the responsibility of individuals without the appropriate scope of practice to make such decisions.
16.12.14.9(B)(5) NMAC (Clinical supervisor) · verified Sep 4, 2026
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Treatments the Department has adopted as the practice of medicine must be performed by, or under the order of, a licensed physician, physician assistant, or nurse practitioner. The supervision required is GENERAL supervision: the supervising physician or nurse practitioner need not be physically present, but must be available to give guidance or to intervene within a reasonable period for the treatment being rendered.
N.Y. State Board for Medicine — Use of Energy Devices Including Lasers as the Practice of Medicine (Mar. 7, 2025) · verified Aug 17, 2026
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It is the position of the Board that good medical practice requires that each patient be examined by a physician, physician assistant, or nurse practitioner licensed or approved by the Board prior to receiving the first laser hair and tattoo removal treatment and at other times as medically indicated; when medication is prescribed or dispensed in connection with laser hair or tattoo removal, the supervising physician shall assure the patient receives thorough instructions on the safe use or application of the medication; and the Board weighs, among other factors, the quality of written protocols for the performance of the procedure.
NCMB Position Statement 5.1.2 (Laser surgery — supervision and written protocols) · verified Sep 8, 2026
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Before a nurse may apply a vascular laser, the physician must ensure they have completed eight hours of basic education covering light-based procedure physics, tissue interaction, safety and proper safety equipment, clinical application, pre- and post-operative care and adverse event reporting; observed fifteen procedures of that specific type; and performed twenty procedures of that type under the physician’s direct physical oversight — meaning the physician in the same room, observing.
Ohio Admin. Code 4731-18-03(A)(7) · verified Sep 1, 2026
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being responsible for the formulation or approval of all orders and protocols, whether standing orders, direct orders or any other orders or protocols, which direct the delivery of health care services provided by a physician assistant, and periodically reviewing such orders and protocols
Okla. Stat. tit. 59, § 519.6(a) (Responsibility for all orders and protocols) · verified Sep 5, 2026
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A physician may approve a standing protocol delegating medical acts to another health care practitioner who encounters a medical emergency, to stabilize the patient until the physician or emergency medical services personnel are available to attend.
49 Pa. Code §18.402 · verified Aug 17, 2026 · read at Cornell Legal Information Institute
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Delegated medical acts are additional acts delegated by a physician or dentist to a physician assistant, respiratory care practitioner, anesthesiologist's assistant, or other practitioner authorized by law under approved written scope of practice guidelines or approved written protocols, and must be performed under the supervision of a physician or dentist who must be readily or immediately available for consultation; and immediately available, for the purpose of supervising unlicensed personnel, means being located within the office and ready for immediate utilization when needed.
S.C. Code §40-47-20(12), (18) · verified Sep 8, 2026
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Protocols are mandatory and have a maintenance schedule: they shall be JOINTLY DEVELOPED AND APPROVED by the supervising physician and the physician assistant, shall outline and cover the applicable standard of care, shall be REVIEWED AND UPDATED BIENNIALLY, and shall be maintained at the practice site.
Tenn. Comp. R. & Regs. 0880-02-.18(5) · verified Sep 2, 2026
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The delegating physician must review, approve, or develop a written order for the delegated procedure that identifies the physician, sets patient-screening criteria, describes appropriate care, and provides procedures for handling common complications.
22 TAC §169.27 · verified Jul 26, 2026 · read at Cornell Legal Information Institute
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To be approved, a microneedling device shall: (a) be used only by a master esthetician: (i) without supervision if needle penetration does not exceed 1.5 mm; or (ii) with general supervision by a licensed health care practitioner if needle penetration exceeds 1.5 mm; and (b) be used specifically for cosmetic or esthetic purposes.
Utah Admin. Code R156-11a-611(5) (Standards for Approval of Mechanical or Electrical Apparatus) · verified Sep 3, 2026
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A physician may delegate LLRP treatment to a supervised professional whose own scope allows it, but only against a WRITTEN OFFICE PROTOCOL carrying seven named elements: the identity of the authorizing physician; the activities, decision criteria and plan the delegate must follow; patient selection criteria; the devices and settings for patients meeting them; how the device is operated and maintained; care and follow-up for complications and emergencies; and the delegate’s documentation and feedback plan.
Wash. Admin. Code 246-919-605(10)(d) · verified Sep 2, 2026
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Delegated medical procedures shall be undertaken only pursuant to formal written protocols setting forth the nature and scope of the procedures delegated, describing the supervisory plan, and indicating any contraindications to undertaking the procedure; a laser hair removal product or device, or intense pulsed light device, shall not be used on a minor unless the minor is accompanied by a parent or guardian and only under the general supervision of a physician; and a licensee providing delegated medical procedures shall upon request make a copy of the formal written protocols available to the client and to the board.
Wis. Admin. Code § Cos 2.025(3)–(4) · verified Sep 8, 2026
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34 of the 51 states for which we publish statute-cited rules. That is not every state, and nothing above should be read as describing one that is not listed — the answer genuinely differs, so a neighbouring state is not a guide. We monitor all 50 state legislatures plus the FDA and the Federal Register daily; the cited rule set is narrower than the monitoring and is growing on its own timetable.
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