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Important: Regulations change frequently. Always verify current requirements with your state licensing board before practicing.

Find Your State's Requirements

Select your state to view specific scope of practice regulations for pain management and aesthetic procedures.

Select a State Above

Choose your state from the dropdown to view detailed scope of practice requirements for pain management and aesthetic procedures.

Full Practice Authority
Reduced Practice
Restricted Practice

NP Practice Authority by State

Understanding which states allow independent practice for Nurse Practitioners is essential for Botox training, dermal filler certification, and pain management procedures.

Full Practice Authority States

NPs can evaluate, diagnose, and treat patients independently including Botox injections, dermal fillers, and pain management procedures.

  • Alaska
  • Arizona
  • Colorado
  • Connecticut
  • Hawaii
  • Idaho
  • Iowa
  • Maine
  • Maryland
  • Minnesota
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Mexico
  • North Dakota
  • Oregon
  • Rhode Island
  • South Dakota
  • Vermont
  • Washington
  • Washington D.C.
  • Wyoming

Reduced Practice States

NPs require a collaborative agreement with a physician for Botox, filler injections, and pain management. Supervision level varies.

  • Alabama
  • Arkansas
  • Delaware
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Louisiana
  • Massachusetts
  • Mississippi
  • New Jersey
  • New York
  • Ohio
  • Pennsylvania
  • Utah
  • West Virginia
  • Wisconsin

Restricted Practice States

NPs require physician supervision or delegation for aesthetic injections and pain procedures. Stricter oversight required.

  • California
  • Florida
  • Georgia
  • Michigan
  • Missouri
  • North Carolina
  • Oklahoma
  • South Carolina
  • Tennessee
  • Texas
  • Virginia

Last Updated: January 2026 | Practice authority classifications based on AANP State Practice Environment

Who Can Inject Botox & Fillers by State?

The ability to perform aesthetic injections like Botox, Dysport, dermal fillers, and Sculptra varies by state and provider type. Here's the general breakdown:

  • Physicians (MD/DO): Can inject Botox and fillers independently in all 50 states
  • Nurse Practitioners: Can inject independently in Full Practice states; require collaboration in others
  • Physician Assistants: Can inject with physician supervision in most states
  • Registered Nurses: Can inject under physician supervision with proper protocols
  • Dentists: Can inject in the facial region in most states for aesthetic purposes
Learn More About Eligibility

Official Resources & Regulatory Bodies

Alabama

Reduced Practice (NP)

Regulatory Board: Alabama Board of Medical Examiners

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Alabama

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Alabama Board of Medical Examiners for the most current scope of practice information.

Alaska

Full Practice (NP)

Regulatory Board: Alaska State Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Alaska

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Alaska State Medical Board for the most current scope of practice information.

Arizona

Full Practice (NP)

Regulatory Board: Arizona Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Arizona

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Arizona Medical Board for the most current scope of practice information.

Arkansas

Reduced Practice (NP)

Regulatory Board: Arkansas State Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Arkansas

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Arkansas State Medical Board for the most current scope of practice information.

California

Restricted Practice (NP)

Regulatory Board: Medical Board of California

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for California

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Medical Board of California for the most current scope of practice information.

Colorado

Full Practice (NP)

Regulatory Board: Colorado Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Colorado

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Colorado Medical Board for the most current scope of practice information.

Connecticut

Full Practice (NP)

Regulatory Board: Connecticut Medical Examining Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Connecticut

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Connecticut Medical Examining Board for the most current scope of practice information.

Delaware

Reduced Practice (NP)

Regulatory Board: Delaware Board of Medical Licensure

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Delaware

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Delaware Board of Medical Licensure for the most current scope of practice information.

District of Columbia

Full Practice (NP)

Regulatory Board: DC Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for District of Columbia

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the DC Board of Medicine for the most current scope of practice information.

Florida

Restricted Practice (NP)

Regulatory Board: Florida Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Florida

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Florida Board of Medicine for the most current scope of practice information.

Georgia

Restricted Practice (NP)

Regulatory Board: Georgia Composite Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Georgia

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Georgia Composite Medical Board for the most current scope of practice information.

Hawaii

Full Practice (NP)

Regulatory Board: Hawaii Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Hawaii

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Hawaii Medical Board for the most current scope of practice information.

Idaho

Full Practice (NP)

Regulatory Board: Idaho Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Idaho

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Idaho Board of Medicine for the most current scope of practice information.

Illinois

Reduced Practice (NP)

Regulatory Board: Illinois Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Illinois

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Illinois Medical Board for the most current scope of practice information.

Indiana

Reduced Practice (NP)

Regulatory Board: Indiana Medical Licensing Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Indiana

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Indiana Medical Licensing Board for the most current scope of practice information.

Iowa

Full Practice (NP)

Regulatory Board: Iowa Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Iowa

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Iowa Board of Medicine for the most current scope of practice information.

Kansas

Reduced Practice (NP)

Regulatory Board: Kansas State Board of Healing Arts

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Kansas

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Kansas State Board of Healing Arts for the most current scope of practice information.

Kentucky

Reduced Practice (NP)

Regulatory Board: Kentucky Board of Medical Licensure

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Kentucky

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Kentucky Board of Medical Licensure for the most current scope of practice information.

Louisiana

Reduced Practice (NP)

Regulatory Board: Louisiana State Board of Medical Examiners

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Louisiana

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Louisiana State Board of Medical Examiners for the most current scope of practice information.

Maine

Full Practice (NP)

Regulatory Board: Maine Board of Licensure in Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Maine

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Maine Board of Licensure in Medicine for the most current scope of practice information.

Maryland

Full Practice (NP)

Regulatory Board: Maryland Board of Physicians

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Maryland

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Maryland Board of Physicians for the most current scope of practice information.

Massachusetts

Reduced Practice (NP)

Regulatory Board: Massachusetts Board of Registration in Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Massachusetts

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Massachusetts Board of Registration in Medicine for the most current scope of practice information.

Michigan

Restricted Practice (NP)

Regulatory Board: Michigan Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Michigan

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Michigan Board of Medicine for the most current scope of practice information.

Minnesota

Full Practice (NP)

Regulatory Board: Minnesota Board of Medical Practice

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Minnesota

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Minnesota Board of Medical Practice for the most current scope of practice information.

Mississippi

Reduced Practice (NP)

Regulatory Board: Mississippi State Board of Medical Licensure

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Mississippi

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Mississippi State Board of Medical Licensure for the most current scope of practice information.

Missouri

Restricted Practice (NP)

Regulatory Board: Missouri State Board of Registration for the Healing Arts

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Missouri

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Missouri State Board of Registration for the Healing Arts for the most current scope of practice information.

Montana

Full Practice (NP)

Regulatory Board: Montana Board of Medical Examiners

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Montana

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Montana Board of Medical Examiners for the most current scope of practice information.

Nebraska

Full Practice (NP)

Regulatory Board: Nebraska Board of Medicine and Surgery

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Nebraska

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Nebraska Board of Medicine and Surgery for the most current scope of practice information.

Nevada

Full Practice (NP)

Regulatory Board: Nevada State Board of Medical Examiners

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Nevada

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Nevada State Board of Medical Examiners for the most current scope of practice information.

New Hampshire

Full Practice (NP)

Regulatory Board: New Hampshire Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for New Hampshire

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the New Hampshire Board of Medicine for the most current scope of practice information.

New Jersey

Reduced Practice (NP)

Regulatory Board: New Jersey Board of Medical Examiners

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for New Jersey

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the New Jersey Board of Medical Examiners for the most current scope of practice information.

New Mexico

Full Practice (NP)

Regulatory Board: New Mexico Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for New Mexico

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the New Mexico Medical Board for the most current scope of practice information.

New York

Reduced Practice (NP)

Regulatory Board: New York State Board for Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for New York

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the New York State Board for Medicine for the most current scope of practice information.

North Carolina

Restricted Practice (NP)

Regulatory Board: North Carolina Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for North Carolina

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the North Carolina Medical Board for the most current scope of practice information.

North Dakota

Full Practice (NP)

Regulatory Board: North Dakota Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for North Dakota

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the North Dakota Board of Medicine for the most current scope of practice information.

Ohio

Reduced Practice (NP)

Regulatory Board: State Medical Board of Ohio

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Ohio

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the State Medical Board of Ohio for the most current scope of practice information.

Oklahoma

Restricted Practice (NP)

Regulatory Board: Oklahoma State Board of Medical Licensure

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Oklahoma

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Oklahoma State Board of Medical Licensure for the most current scope of practice information.

Oregon

Full Practice (NP)

Regulatory Board: Oregon Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Oregon

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Oregon Medical Board for the most current scope of practice information.

Pennsylvania

Reduced Practice (NP)

Regulatory Board: Pennsylvania State Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Pennsylvania

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Pennsylvania State Board of Medicine for the most current scope of practice information.

Rhode Island

Full Practice (NP)

Regulatory Board: Rhode Island Board of Medical Licensure

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Rhode Island

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Rhode Island Board of Medical Licensure for the most current scope of practice information.

South Carolina

Restricted Practice (NP)

Regulatory Board: South Carolina Board of Medical Examiners

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for South Carolina

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the South Carolina Board of Medical Examiners for the most current scope of practice information.

South Dakota

Full Practice (NP)

Regulatory Board: South Dakota Board of Medical and Osteopathic Examiners

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for South Dakota

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the South Dakota Board of Medical and Osteopathic Examiners for the most current scope of practice information.

Tennessee

Restricted Practice (NP)

Regulatory Board: Tennessee Board of Medical Examiners

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Tennessee

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Tennessee Board of Medical Examiners for the most current scope of practice information.

Texas

Restricted Practice (NP)

Regulatory Board: Texas Medical Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Texas

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Texas Medical Board for the most current scope of practice information.

Utah

Reduced Practice (NP)

Regulatory Board: Utah Division of Occupational and Professional Licensing

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Utah

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Utah Division of Occupational and Professional Licensing for the most current scope of practice information.

Vermont

Full Practice (NP)

Regulatory Board: Vermont Board of Medical Practice

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Vermont

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Vermont Board of Medical Practice for the most current scope of practice information.

Virginia

Restricted Practice (NP)

Regulatory Board: Virginia Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Physician Supervision
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Virginia

  • NP Practice Authority: Restricted Practice - NPs require physician supervision or delegation for prescriptive authority and procedures.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Virginia Board of Medicine for the most current scope of practice information.

Washington

Full Practice (NP)

Regulatory Board: Washington Medical Commission

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Washington

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Washington Medical Commission for the most current scope of practice information.

West Virginia

Reduced Practice (NP)

Regulatory Board: West Virginia Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for West Virginia

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the West Virginia Board of Medicine for the most current scope of practice information.

Wisconsin

Reduced Practice (NP)

Regulatory Board: Wisconsin Medical Examining Board

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners Supervision Required
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners Collaborative Agreement
Physician Assistants Supervision Required

Key Requirements for Wisconsin

  • NP Practice Authority: Reduced Practice - NPs require a collaborative agreement with a physician but may have some independent functions.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Wisconsin Medical Examining Board for the most current scope of practice information.

Wyoming

Full Practice (NP)

Regulatory Board: Wyoming Board of Medicine

Aesthetic Procedures

Scope of practice for aesthetic procedures including neurotoxins, dermal fillers, and laser treatments.

Neurotoxins (Botox, Dysport)

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Dermal Fillers

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required
Registered Nurses Physician Supervision
Dentists (DDS/DMD) Facial Region

Pain Management Procedures

Scope of practice for interventional pain management procedures including joint injections, trigger point injections, nerve blocks, and spinal procedures.

Joint & Trigger Point Injections

Physicians (MD/DO) Independent
Nurse Practitioners Independent
Physician Assistants Supervision Required

Nerve Blocks

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Spinal Injections

Physicians (MD/DO) Independent
Nurse Practitioners Supervision + Credentialing
Physician Assistants Supervision + Credentialing

Ultrasound-Guided Procedures

Physicians (MD/DO) Independent
Nurse Practitioners With Training
Physician Assistants Supervision Required

Key Requirements for Wyoming

  • NP Practice Authority: Full Practice - NPs can practice independently without physician oversight after meeting state requirements.
  • PA Requirements: Physician Assistants must maintain a supervisory agreement with a licensed physician. Supervision requirements vary by practice setting.
  • RN Requirements: Registered Nurses performing injections must work under physician supervision with established protocols and standing orders.
  • Pain Management: Interventional procedures may require facility credentialing and specific training documentation.
  • Verify Current Regulations: Contact the Wyoming Board of Medicine for the most current scope of practice information.

Understanding NP Practice Authority

Nurse Practitioner scope of practice varies significantly by state. Here's what each category means for pain management and aesthetic procedures.

Full Practice

Full Practice Authority

NPs can evaluate, diagnose, interpret diagnostic tests, and initiate treatment plans including procedures without physician oversight.

Pain Management Impact:

  • Can perform joint injections independently
  • May perform nerve blocks with appropriate training
  • Can prescribe controlled substances for pain
  • Hospital credentialing still required for facility-based procedures
Reduced Practice

Reduced Practice

NPs require a collaborative agreement with a physician for at least one element of practice, typically prescriptive authority.

Pain Management Impact:

  • Collaborative agreement required
  • May perform procedures within agreement scope
  • Prescriptive authority tied to collaboration
  • Physician must be available for consultation
Restricted Practice

Restricted Practice

NPs require physician supervision, delegation, or team management for clinical practice elements.

Pain Management Impact:

  • Direct physician supervision often required
  • Procedures must be delegated by physician
  • More restrictive prescribing limitations
  • Supervision documentation required

Important Disclaimer

The information provided on this page is for educational purposes only and should not be considered legal or medical advice. Scope of practice regulations:

  • Change frequently through legislation and regulatory updates
  • May have exceptions or specific conditions not covered here
  • Vary by practice setting (hospital, clinic, medical spa)
  • May require additional credentials, training, or certifications

Always verify current requirements with your state medical board, nursing board, or appropriate licensing authority before performing any procedures. Consider consulting with a healthcare attorney for specific questions about your scope of practice.

Frequently Asked Questions

Common questions about state scope of practice for pain management and aesthetic procedures.

Can NPs perform pain management procedures independently?

It depends on your state's practice authority. In Full Practice Authority states, NPs can perform procedures within their training and competency independently. In Reduced and Restricted Practice states, a collaborative agreement or physician supervision is required. Additionally, facility credentialing may impose additional requirements regardless of state law.

What supervision do RNs need to perform injections?

In all states, RNs require physician supervision to perform injections such as Botox, fillers, or pain management procedures. The supervising physician must establish protocols, standing orders, and be available for consultation. Some states require on-site supervision while others allow general supervision with the physician available by phone.

Can PAs perform spinal injections?

PAs can perform spinal injections in most states with appropriate physician supervision, training, and facility credentialing. The supervising physician's scope of practice must include these procedures. Hospital and surgery center credentialing committees typically require documentation of training and competency assessment.

Do requirements differ for medical spas vs. clinics?

Yes, many states have specific regulations for medical spas that differ from traditional clinical settings. Some states require a physician medical director to be on-site during procedures, while others allow remote supervision. States like Florida have specific medical spa regulations that practitioners must follow.

What happens if I practice outside my scope?

Practicing outside your scope can result in disciplinary action by your licensing board, including fines, license suspension, or revocation. It may also void your malpractice insurance coverage and expose you to civil liability. Always verify your scope of practice before performing any procedure.

Is training sufficient to perform procedures in my state?

Training is necessary but may not be sufficient. You must also have the appropriate license, scope of practice, and in many cases, supervision arrangements or collaborative agreements. Facility credentialing, malpractice insurance coverage, and any state-specific certifications must also be in place.

Can I perform procedures in multiple states?

You must hold a valid license in each state where you practice. Each state's scope of practice rules apply independently, so a procedure you can perform independently in one state may require supervision in another. The Nurse Licensure Compact (NLC) allows some nurses to practice across member states, but scope of practice still varies.

How do I find my state's specific regulations?

Contact your state medical board (for physicians and PAs), board of nursing (for NPs and RNs), or dental board (for dentists). Most boards have scope of practice information on their websites. Professional associations like AANP, AAPA, and state medical societies can also provide guidance.

Can nurses inject Botox in California?

In California, RNs can inject Botox and dermal fillers under physician supervision with standardized procedures established by the supervising physician. California NPs operate under Restricted Practice authority, meaning they require physician supervision for certain functions including prescriptive authority. California also has specific regulations for medical spas. AAOPM's Botox training prepares practitioners for California's requirements.

What states allow NPs to practice independently?

Full Practice Authority states where NPs can practice independently include: Alaska, Arizona, Colorado, Connecticut, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, Wyoming, and Washington D.C. In these states, NPs can perform Botox injections, dermal fillers, and other procedures without physician oversight.

Can dentists inject Botox for cosmetic purposes?

In most states, dentists (DDS/DMD) can inject Botox and dermal fillers within the head, neck, and oral/maxillofacial region. Many state dental boards explicitly allow facial aesthetic procedures as part of dental practice. Dentists are particularly well-suited for these procedures due to their extensive facial anatomy training. AAOPM offers Botox training specifically designed for dentists.

What is the difference between Full Practice and Restricted Practice for NPs?

Full Practice Authority allows NPs to evaluate, diagnose, order and interpret diagnostic tests, and manage treatment including prescribing medications and performing procedures independently without physician oversight. Restricted Practice requires physician supervision, delegation, or team management for at least one element of NP practice, often including prescriptive authority and the ability to perform procedures like interventional pain management or aesthetic injections.

Ready to Expand Your Procedural Skills?

AAOPM offers hands-on training in aesthetic and pain management procedures for licensed healthcare professionals. Our courses help you build the skills needed to practice within your state's scope.

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