Texas scope of practice for med spas

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

For laser therapy performed by RNs or LVNs, the Board of Nursing directs nurses to the Texas Medical Board’s delegation rule for nonsurgical cosmetic procedures and to the Health & Safety Code’s laser provisions.

Tex. BON Position Statement 15.9 · verified Jul 26, 2026

The APRN acts independently, under the delegated authority of a physician and/or in collaboration with other health care professionals in the delivery of health care services, and APRNs utilize mechanisms, including protocols, prescriptive authority agreements, or other written authorization, that provide them with the authority to provide medical aspects of care, including the ordering of dangerous drugs, controlled substances, or devices that bear a federal prescription legend.

Texas BON Position Statement 15.18 (Nurses Carrying out Orders from Advanced Practice Registered Nurses) · verified Sep 8, 2026

Texas defines the physician assistant’s practice as delegated practice, and the injection sits inside it. “The practice of a physician assistant includes providing medical services delegated by a supervising physician that are within the education, training, and experience of the physician assistant.” The enumerated services include “ordering or performing diagnostic and therapeutic procedures” and “prescribing or ordering a drug or device as provided by Subchapter B” of Chapter 157. The relationship is stated as agency: “A physician assistant is the agent of the physician assistant’s supervising physician for any medical services that are delegated by that physician” and that “are delineated by protocols, practice guidelines, or practice directives established by the supervising physician”.

Tex. Occ. Code § 204.202(a)-(b), (e) (Scope of practice) · verified Sep 8, 2026

Prescribing takes a separate written instrument, and the physician’s side of it is capped. “a physician may delegate to an advanced practice registered nurse or physician assistant, acting under adequate physician supervision, the act of prescribing or ordering a drug or device as authorized through a prescriptive authority agreement” between them. “the combined number of advanced practice registered nurses and physician assistants with whom a physician may enter into a prescriptive authority agreement may not exceed seven”, or their full-time equivalent — a limit that does not apply to a practice serving a medically underserved population or to a facility-based practice.

Tex. Occ. Code § 157.0512(a), (c)-(d) (Prescriptive authority agreement) · verified Sep 8, 2026