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Who Can Legally Perform Botox and Fillers: A State-by-State Guide

By: Nextech | November 8th, 2024

Who Can Legally Perform Botox and Fillers: A State-by-State Guide Blog Feature

Interest in aesthetic procedures, including Botox and dermal fillers, has increased 40% over the last four years. As a plastic surgery or dermatology practice or a med spa, you are well positioned to perform these procedures — so long as you understand and follow the legal requirements around who can administer Botox and dermal fillers. 

The answer depends on your state, as does any additional certifications or requirements to conduct these two popular procedures. To help, we’ve compiled a list of state-by-state laws and regulations around who can perform these procedures. 

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 | Virginia | Washington | West Virginia | Wisconsin | Wyoming 

State-Specific Regulations in 2024

Who can perform Botox and fillers differs from state to state. To help you determine who in your med spa or medical practice can perform Botox and fillers, we gathered the most up-to-date, state-specific regulations and laws. 

See also: who can legally own med spas and med spa laws by state.

Alabama

Who can perform Botox and fillers?

In Alabama, licensed physicians can perform Botox and fillers.

Training requirements beyond certification?

In Alabama, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Alabama, practices must have an informed consent process in place and carry malpractice insurance.

Alaska 

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in Alaska. Other medical professionals with aesthetics training, such as aesthetic nurses, can as well with physician supervision.

Training requirements beyond certification?

There are no additional qualifications for physicians in Alaska. Other medical professionals need aesthetic training. 

Any ethical considerations? 

In Alaska, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Arizona

Who can perform Botox and fillers?

In Arizona, licensed physicians can perform Botox and fillers. Licensed nurses can as well, with the supervision of a physician. 

Training requirements beyond certification?

In Arizona, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Arizona, practices must have an informed consent process in place and carry malpractice insurance.

Arkansas

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in Arkansas. RNs and NPs can as well, if the procedure is part of a treatment plan prescribed by a physician. 

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Arkansas.

Any ethical considerations? 

In Arkansas, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

California

Who can perform Botox and fillers?

In California, oral surgeons can perform Botox and fillers.

Training requirements beyond certification?

In California, oral surgeons must hold an elective facial cosmetic surgery permit to perform these services.

Any ethical considerations? 

When performing these procedures in California, practices must have an informed consent process in place and carry malpractice insurance.

Colorado

Who can perform Botox and fillers?

NPs, PAs, and licensed physicians can perform Botox and fillers in Colorado. Nurses and estheticians can as well, with physician supervision. 

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Colorado.

Any ethical considerations? 

In Colorado, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Connecticut 

Who can perform Botox and fillers?

In Connecticut, licensed healthcare providers can perform Botox and fillers.

Training requirements beyond certification?

In Connecticut, there are no additional qualifications, though someone must prove a procedure is within their medical scope of practice. 

Any ethical considerations? 

When performing these procedures in Connecticut, practices must have an informed consent process in place and carry malpractice insurance.

Delaware

Who can perform Botox and fillers?

LPNs, RNs, physicians, and NPs can perform Botox and fillers in Delaware.

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Delaware.

Any ethical considerations? 

In Delaware, Botox or fillers must be prescribed by a physician with prescribing capabilities.

Florida

Who can perform Botox and fillers?

In Florida, licensed physicians can perform Botox and fillers. NPs or PAs can as well, under the supervision of a physician. 

Training requirements beyond certification?

In Florida, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Florida, practices must have an informed consent process in place and carry malpractice insurance.

Georgia

Who can perform Botox and fillers?

Licensed physicians and dentists can perform Botox and fillers in Georgia.

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Georgia.

Any ethical considerations? 

In Georgia, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Hawaii

Who can perform Botox and fillers?

In Hawaii, licensed physicians or PAs can perform Botox and fillers.

Training requirements beyond certification?

In Hawaii, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Hawaii, practices must have an informed consent process in place and carry malpractice insurance.

Idaho

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in Idaho.

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Idaho.

Any ethical considerations? 

In Idaho, practices should make sure to have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Illinois

Who can perform Botox and fillers?

In Illinois, RNs, NPs, PAs, and physicians can perform Botox and fillers.

Training requirements beyond certification?

In Illinois, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

A good faith medical exam by a physician must be completed before Botox or dermal fillers are performed in Illinois. 

Indiana

Who can perform Botox and fillers?

Licensed physicians or nurse practitioners can perform Botox and fillers in Indiana.

Training requirements beyond certification?

There are no additional qualifications, though physicians or NPs must prove they have the necessary expertise and education before performing these procedures in Indiana.

Any ethical considerations?

In Indiana, practices should make sure to have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Iowa

Who can perform Botox and fillers?

In Iowa, licensed physicians can perform Botox and fillers. In certain situations, physicians may be able to outsource these duties to other licensed professionals under their supervision.

Training requirements beyond certification?

In Iowa, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Iowa, practices must have an informed consent process in place and carry malpractice insurance.

Kansas

Who can perform Botox and fillers?

Medical professionals holding a DO, DDS, DMD, NP, or MD license can perform Botox and fillers in Kansas. Nurses can do so under physician supervision. 

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Kansas.

Any ethical considerations? 

In Kansas, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Kentucky

Who can perform Botox and fillers?

In Kentucky, any licensed medical professional can perform Botox and fillers when under the supervision of a physician. This includes licensed estheticians, with “immediate” supervision from a physician. 

Training requirements beyond certification?

In Kentucky, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Kentucky, practices must have an informed consent process in place and carry malpractice insurance.

Louisiana 

Who can perform Botox and fillers?

Licensed practical nurses, RNs, PAs, NPs, and physicians can perform Botox and fillers in Louisiana.

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Louisiana.

Any ethical considerations? 

In Louisiana, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Maine

Who can perform Botox and fillers?

In Maine, PAs, nurses, and licensed physicians can perform Botox and fillers.

Training requirements beyond certification?

In Maine, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Maine, practices must have an informed consent process in place and carry malpractice insurance.

Maryland

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in Maryland.

Training requirements beyond certification?

Physicians must have additional training from a higher education institution in these procedures before performing them in Maryland.

Any ethical considerations? 

In Maryland, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Massachusetts

Who can perform Botox and fillers?

In Massachusetts, licensed medical professionals can perform Botox and fillers. This includes LPNs, RNs, NPs, PAs, dentists, and physicians. 

Training requirements beyond certification?

In Massachusetts, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Massachusetts, practices must have an informed consent process in place and carry malpractice insurance.

Michigan

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in Michigan. Other medical professionals can as well, under the supervision of a physician. 

Training requirements beyond certification?

There are no additional qualifications for licensed physicians in Michigan. Other professionals need to demonstrate the necessary education and expertise to perform these procedures. 

Any ethical considerations? 

In Michigan, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Minnesota

Who can perform Botox and fillers?

In Minnesota, licensed physicians can perform Botox and fillers.

Training requirements beyond certification?

In Minnesota, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Minnesota, practices must have an informed consent process in place and carry malpractice insurance. For Botox specifically, a patient must have a prescription from a licensed physician since it’s not an over-the-counter procedure in Minnesota. 

Mississippi 

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in Mississippi. RNs, NPs, PAs, and electrologists may as well, with the supervision of a licensed physician. 

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Mississippi.

Any ethical considerations? 

In Mississippi, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Missouri

Who can perform Botox and fillers?

In Missouri, professionals who hold a DO, DDS, DMD, MD, or NP can perform Botox and fillers. RNs can perform these services with physician supervision. 

Training requirements beyond certification?

In Missouri, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Missouri, practices must have an informed consent process in place and carry malpractice insurance.

Montana 

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in Montana.

Training requirements beyond certification?

There are no additional qualifications required, though Montana law states physicians must have the education and experience to perform these procedures. 

Any ethical considerations? 

In Montana, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Nebraska

Who can perform Botox and fillers?

In Nebraska, licensed physicians can perform Botox and fillers.

Training requirements beyond certification?

In Nebraska, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Nebraska, practices must have an informed consent process in place and carry malpractice insurance.

Nevada

Who can perform Botox and fillers?

Licensed physicians, dentists, podiatrists, PAs, NPs, and RNs can perform Botox and fillers in Nevada.

Training requirements beyond certification?

Dentists must go through additional training in Nevada. 

Any ethical considerations? 

In Nevada, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

New Hampshire

Who can perform Botox and fillers?

In New Hampshire, licensed physicians, NPs, RNs, and PAs can perform Botox and fillers.

Training requirements beyond certification?

In New Hampshire, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in New Hampshire, practices must have an informed consent process in place and carry malpractice insurance.

New Jersey

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in New Jersey.

Training requirements beyond certification?

New Jersey requires specialized training in these procedures from a higher education institution.

Any ethical considerations? 

In New Jersey, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

New Mexico

Who can perform Botox and fillers?

In New Mexico, dentists, physicians, PAs, RNs, and NPs can perform Botox and fillers.

Training requirements beyond certification?

In New Mexico, qualified medical professionals must complete 16 hours of training specific to dermal fillers and Botox.  

Any ethical considerations? 

When performing these procedures in New Mexico, practices must have an informed consent process in place and carry malpractice insurance.

New York

Who can perform Botox and fillers?

Any medical professionals licensed by the state can perform Botox and fillers in New York.

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in New York.

Any ethical considerations? 

In New York, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

North Carolina

Who can perform Botox and fillers?

In North Carolina, physicians, PAs, RNs, and NPs can perform Botox and fillers.

Training requirements beyond certification?

In North Carolina, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in North Carolina, practices must have an informed consent process in place and carry malpractice insurance.

North Dakota

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in North Dakota. There are some exceptions when a PA, NP, or RN can perform a procedure with injectables. 

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in North Dakota.

Any ethical considerations? 

In North Dakota, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Ohio

Who can perform Botox and fillers?

In Ohio, physicians, dentists, PAs, RNs, and NPs can perform Botox and fillers.

Training requirements beyond certification?

In Ohio, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Ohio, practices must have an informed consent process in place and carry malpractice insurance.

Oklahoma

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in Oklahoma.

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Oklahoma.

Any ethical considerations? 

In Oklahoma, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Oregon

Who can perform Botox and fillers?

In Oregon, licensed medical professionals can perform Botox and fillers.

Training requirements beyond certification?

In Oregon, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Oregon, practices must have an informed consent process in place and carry malpractice insurance.

Pennsylvania

Who can perform Botox and fillers?

Licensed medical professionals can perform Botox and fillers in Pennsylvania.

Training requirements beyond certification?

There are no additional qualifications required beyond an active license and medical training from a higher education institution in Pennsylvania.

Any ethical considerations? 

In Pennsylvania, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Rhode Island

Who can perform Botox and fillers?

In Rhode Island, RNs, LPNs, PAs, physicians, and dentists can perform Botox and fillers.

Training requirements beyond certification?

In Rhode Island, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Rhode Island, practices must have an informed consent process in place and carry malpractice insurance.

South Carolina

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in South Carolina.

Training requirements beyond certification?

Licensed physicians in South Carolina need to have continuing education credits in aesthetic procedures to perform these services.

Any ethical considerations? 

In South Carolina, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

South Dakota

Who can perform Botox and fillers?

In South Dakota, licensed physicians can perform Botox and fillers. APRNs, PAs, and RNs can also perform these procedures, under the supervision of a licensed practitioner. 

Training requirements beyond certification?

In South Dakota, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in South Dakota, practices must have an informed consent process in place and carry malpractice insurance.

Tennessee 

Who can perform Botox and fillers?

Qualified healthcare or allied health professionals can perform Botox and fillers in Tennessee.

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Tennessee.

Any ethical considerations? 

In Tennessee, Botox and fillers can be performed anywhere, including in homes, but the setting must meet certain sanitary standards.  

Texas

Who can perform Botox and fillers?

In Texas, any licensed medical professional can perform Botox and fillers. Some licensed professionals can only do so under physician supervision.

Training requirements beyond certification?

In Texas, there are no additional qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Texas, practices must have an informed consent process in place and carry malpractice insurance.

Utah

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in Utah.

Training requirements beyond certification?

There are no advanced qualifications required beyond a professional license in Utah.

Any ethical considerations? 

In Utah, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Vermont

Who can perform Botox and fillers?

In Vermont, any licensed medical professional can perform Botox and fillers.

Training requirements beyond certification?

In Vermont, a special license may be required for certain aesthetic procedures, and certain medical professionals may need aesthetics training before performing Botox or fillers.

Any ethical considerations? 

When performing these procedures in Vermont, practices must have an informed consent process in place and carry malpractice insurance.

Virginia

Who can perform Botox and fillers?

Licensed physicians and physician’s assistants can perform Botox and fillers in Virginia.

Training requirements beyond certification?

There are no additional qualifications required beyond a professional license in Virginia.

Any ethical considerations? 

In Virginia, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Washington

Who can perform Botox and fillers?

In Washington, licensed physicians can perform Botox and fillers.

Training requirements beyond certification?

In Washington, physicians must be trained in nonsurgical aesthetic procedures before performing Botox or fillers. 

Any ethical considerations? 

When performing these procedures in Washington, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

West Virginia

Who can perform Botox and fillers?

Licensed physicians can perform Botox and fillers in West Virginia.

Training requirements beyond certification?

Physicians need appropriate aesthetic training to perform these services in West Virginia, but there is no formal training or qualifications specified.

Any ethical considerations? 

In West Virginia, practices that perform these procedures must have an informed consent process in place and carry malpractice insurance.

Wisconsin

Who can perform Botox and fillers?

In Wisconsin, physicians, PAs, and APRNs can perform Botox and fillers.

Training requirements beyond certification?

In Wisconsin, there are no specialized qualifications required beyond a professional license. 

Any ethical considerations? 

When performing these procedures in Wisconsin, practices should have an informed consent process in place, carry malpractice insurance, and ensure no advertising for services is false or misleading. 

Wyoming

Who can perform Botox and fillers?

Licensed physicians, physician’s assistants, and nurse practitioners can perform Botox and fillers in Wyoming.

Training requirements beyond certification?

There are no specialized qualifications or training required in Wyoming.

Any ethical considerations? 

In Wyoming, practices must have an informed consent process in place and carry malpractice insurance.

What are Botox and dermal fillers? 

Still have questions around what Botox and dermal fillers are? Let’s look at each in more detail and investigate who (generally) can perform these procedures. 

Botox

Botox is a drug that can smooth wrinkles, among other health benefits. While this drug is versatile, it’s most commonly used in anti-aging procedures. 8.8 million procedures with Botox are performed worldwide each year, making it the most common non-surgical procedure.

Dermal Fillers

Dermal fillers are injectable implants that can produce a variety of desired aesthetic effects, such as a more chiseled facial shape or fuller lips. They are becoming increasingly popular, though they haven’t reached the notoriety of Botox yet. It’s also becoming easier to insert dermal fillers (and get better results) thanks to new technologies, such as JUVÉDERM VOLUX XC, a FDA-approved gel implant/dermal filler.

Who Can Perform Botox and Fillers?

The answer depends on what state you reside in. Generally, there are multiple licensed healthcare professionals who can perform Botox in one or more state.

Depending on your license and state, you may need additional training or advanced certification to perform these procedures. Some states group dentists in with “licensed physicians” while others view them as two separate groups of medical professionals. 

Some individuals, such as licensed estheticians or licensed nurses, may also require physician supervision to complete the procedure or aesthetics-specific training — or may not be able to perform these procedures at all in your state. 

Technological Advances in Administering Injectables

New technologies are making it easier to implant fillers or Botox and create a more natural look. One of the most common technologies is JUVÉDERM VOLUX XC, the FDA-approved gel implant/dermal filler mentioned above.

AI and virtual reality are also transforming aesthetic procedure outcomes. AI, for example, can improve filler and Botox administration. Virtual reality and augmented reality can improve surgical accuracy and precision, as well as serve as educational tools for medical students and new doctors.

Risk Management and Legal Liabilities

When administering Botox and dermal fillers, you could be liable if something goes wrong. Liability requirements differ from state to state. Plus, fraudulent Botox products are currently circulating, increasing risk with this procedure. Plus, these industry-specific risks are on top of the legal liabilities and regulations from HIPAA and the 21st Century Cures Act.

Fortunately, you don’t have to tackle these liabilities alone. An EHR designed for your industry can help you navigate regulations and minimize risk. To learn more, schedule a demo of Nextech’s technology platforms for plastic surgery, dermatology, or med spa.