

Now that the FDA has officially declared the semaglutide shortage over, patients and prescribers across the country are back to relying on Novo Nordisk to supply the diabetes and weight-loss medication. Regulations about who can prescribe and administer semaglutide, however, continue to vary from state to state.
Who Can Legally Prescribe and Administer Semaglutide?
There is no way to get semaglutide, marketed under the brand names Ozempic and Wegovy, without a prescription. In many states, semaglutide can only be prescribed by a physician or nurse practitioner, though some states also grant prescriptive authority to physician assistants and advanced practice registered nurses.
The FDA has approved semaglutide for management of type 2 diabetes and weight management for adults with a BMI over 30. It can be prescribed to adults with a BMI over 27 if the patient also has a weight-related medical condition.
Some states have additional requirements. For example, Connecticut requires patients on semaglutide to participate in a counseling and wellness program in conjunction with their treatment.
See Also: Med Spa Laws by State
Legally, semaglutide can be prescribed online, as long as the provider has prescriptive authority. Some states, like Arkansas, require the initial patient exam be done in person, though they allow telemedicine for follow-up visits.
Telemedicine laws in most states require online visits meet the same standard of care as in-person visits. So if a test or measurement would be considered during an in-person exam, it should be ordered for the telemedicine exam, too.
Best Practices for Offering Semaglutide
When offering semaglutide at your clinic or med spa, there are some best practices you should follow in every state.
- Build a patient-provider relationship
- Document the patient assessment
- Be careful with your advertising
Build a Patient-Provider Relationship
Some states require a documented relationship between a patient and the provider prescribing their weight-loss drugs. Some don’t. Whether your state requires it or not, a patient-provider relationship is always a good idea for someone on a long-term treatment plan like semaglutide.
The more time a provider is able to spend listening and getting to know their patient, the more likely they are to develop an effective treatment plan. This relationship doesn’t end once the prescription is written; regular check-ins are important to assess how the patient is doing on the medication and if their treatment needs to be adjusted.
Document Patient Assessment
Semaglutide affects appetite, digestion, and blood sugar. While this multipronged effect is what makes it effective, it also creates multiple avenues where it can seriously impact a patient’s health.
To protect your patients’ health and your own liability, providers should have a clear, documented process they follow every time when deciding if a patient is a candidate for semaglutide drugs. A second process, also clearly documented, should outline continuing patient monitoring and evaluation.
Be Careful When Advertising Semaglutide
If you decide to mention Wegovy, Ozempic, or semaglutide by name in your clinic or med spa marketing, be careful not to make any promises about weight loss.
State and federal advertising regulations are strict. Any marketing materials that mention drugs by name must be provably accurate and true. They must not be misleading or make any promises you can’t guarantee.
Semaglutide Laws By State
If your clinic or med spa is considering offering semaglutide for weight loss, be sure to check with your state medical board first. This list of regulations is not exhaustive, and state laws often change..
Alabama | Alaska | Arizona | Arkansas | California | Colorado | Connecticut | Delaware | Florida | Georgia | Hawaii | Idaho | Illinois | Indiana | Iowa | Kansas | Kentucky | Louisiana | Maine | Maryland | Massachusetts | Michigan | Minnesota | Mississippi | Missouri | Montana | Nebraska | Nevada | New Hampshire | New Jersey | New Mexico | New York | North Carolina | North Dakota | Ohio | Oklahoma | Oregon | Pennsylvania | Rhode Island | South Carolina | South Dakota | Tennessee | Texas | Utah | Vermont | Viriginia | Washington | West Virginia | Wisconsin | Wyoming
Alabama
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Alaska
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Arizona
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Arkansas
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California
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Colorado
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Connecticut
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Delaware
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Florida
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Georgia
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Hawaii
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Idaho
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Illinois
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Indiana
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Iowa
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Kansas
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Kentucky
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Louisiana
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Maine
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Maryland
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Massachusetts
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Michigan
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Minnesota
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Mississippi
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Missouri
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Montana
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Nebraska
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Nevada
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New Hampshire
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New Jersey
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New Mexico
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New York
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North Carolina
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North Dakota
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Ohio
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Oklahoma
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Oregon
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Pennsylvania
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Rhode Island
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South Carolina
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South Dakota
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Tennessee
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Texas
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Utah
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Vermont
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Virginia
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Washington
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West Virginia
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Wisconsin
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Wyoming
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2025 Changes to Semaglutide Laws
Semaglutide is the active ingredient in GLP-1RA drugs that regulate appetite and blood sugar. Novo Nordisk’s first semaglutide drug, Ozempic, was approved in 2017 to treat Type 2 diabetes.
After doctors noticed their patients experienced rapid weight loss on Ozempic, the company released a second semaglutide drug, Wegovy, which was approved for weight loss in 2021.
The weight loss craze that followed led to a shortage of semaglutide in 2022. To address the shortage, the FDA allowed compounded versions of the drug. The market was flooded with compounds, some using types and grades of semaglutide that have not been proven safe and effective.
In February 2025, the FDA declared that Novo Nordisk had increased manufacturing capabilities enough to keep up with demand, and the shortage was over. Pharmacies and practices will no longer be able sell compounded semaglutide after April 22.
Caring for Patients on Semaglutide
Patients on semaglutide drugs need careful monitoring and management. There are downsides to losing weight too rapidly, and it’s important the patient understands these.
Any clinic or med spa that prescribes semaglutide should have documented protocols around the drug. These protocols should lay out clear criteria for determining if a patient is eligible, whether and when to adjust the dosage, and how to handle side effects.
Documenting these processes not only makes successful outcomes more likely, but may protect you and your practice from regulatory and legal action.
In the initial exam, educate patients about the treatment. They may have been dazzled by the success stories they’ve heard from the media and people in their lives but don’t fully understand the potential risks and side effects.
The exam should be performed by a qualified medical provider and should look at more than BMI. You are treating a person, not just a condition. Consider their complete health history, including pre-existing conditions, contraindications, lab results, and lifestyle.
Your patient needs to understand that no weight loss treatment is one and done. You’ll need to set up a long-term plan to keep patients on track. Schedule regular follow-up visits to track progress, monitor side effects, and adjust dosage.
An intuitive technology platform is a valuable tool in these follow-up visits. You can visually track progress at a glance, record a variety of health and lifestyle data points, and get alerted to potential negative outcomes.
Lifestyle is a key factor in an effective weight management plan. Encourage patients to exercise regularly, and work with dietitians and nutritionists to offer ongoing nutritional support. Semaglutide’s appetite-suppressing quality means the typical patient will consume fewer calories. A healthy diet is important to make sure the food they eat provides the nutrition they need.
Modern technology makes referring patients to nutritionists, dietitians, and other providers simple. Intelligent software can help you find referral partners, send pre-filled referral letters with a click, and share patient health data with one another. It can also track which partners are referring the most patients to you.
Collecting Payment for Semaglutide Treatments
Semaglutide is famously expensive. Out-of-pocket costs are typically in the range of $1,000 a month, and insurance coverage is variable, particularly if weight loss is not treating an urgent medical need.
Before beginning a treatment plan, prequalify the prescription with the patient’s insurer. Tell the patient in advance what their out-of-pocket costs are likely to be, so they don’t start a plan they can’t afford.
To ensure quick and complete reimbursement from insurers, make sure your billing team knows and uses the right codes.
- The ICD-10 code for obesity and overweight is E66, with extensions for morbid obesity, obesity by cause, and obesity by class
- The CPT code for the injection is 96372
Also make sure the exam and risk factor reduction counseling are coded separately from the injection. A practice management system with built-in coding and billing tools takes the load off your staff and helps make sure claims are coded correctly before they go out.
Since insurance coverage varies widely, even patients with insurance may have to pick up a hefty tab. Payment installment plans can make treatment more affordable. Patients on a manageable payment plan are more likely to make their payments on time, improving your cash flow.
The Right Technology Helps Med Spas Stay Legally Compliant
Med spas navigate a thorny maze of rules, regulations, and best practices – not just around semaglutide, but around all the treatments they offer.
Nextech developed technology specifically for the unique needs of med spas. This technology helps practices stay legally compliant, provide outstanding patient care, and operate a lean, profitable business.
Request a demo today to see what Nextech can offer your practice.
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