Who Can Legally Perform Injectable Neuromodulators and Fillers: A State-by-State Guide
By: Nextech | November 8th, 2024
A cultural focus on looking young but natural has created high ongoing demand for injectable neuromodulators and dermal fillers. With minimal required equipment, these injectables can be a high profit center for your med spa.
Neuromodulators can relax wrinkles, improve facial symmetry, treat acne, and fix a gummy smile. Dermal fillers can enhance lips, plump up deep lines, and restore the appearance of aging hands.
Patients love injectables for their minimal downtime, affordable price point, and natural-looking results. Since they are FDA-regulated medical treatments, make sure your med spa knows all the rules and regulations around their use.
State by State: Who Can Administer Aesthetic Injections
What Are Neuromodulators and Dermal Fillers and How Do They Work?
Neuromodulators are injectable forms of botulinim toxin. They force the muscle at the site of the injection to relax by blocking the neurotransmitters that signal contractions.
The five FDA-approved injectable neuromodulators are approved to treat wrinkles in specific areas of the face. Popular off-label uses include relaxing neck bands for a smoother neck, relaxing the upper lip to improve the appearance of a smile, and slimming the jaw line through masseter reduction.
The toxin also blocks nerve signals to sweat glands, making it an effective treatment for hyperhidrosis, and oil glands, making it a viable treatment for acne.
When recommending a neuromodulator for an off-label use, no matter how common, protect yourself from liability by making sure the patient understands it’s an off-label application.
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. It’s also becoming easier to insert dermal fillers (and get better results) thanks to new technologies, such as this FDA-approved gel implant/dermal filler.
Who Can Administer Injectable Neuromodulators and Dermal Fillers?
Licensed physicians are the only clinicians approved to administer neuromodulator and dermal filler injections in all 50 states.
Clinicians allowed to administer aesthetic injections in some, but not all, states include:
- Nurse practitioners
- APRNs
- Physician assistants
- Registered nurses
- Licensed practical nurses
- Dentists
- Oral surgeons (California only)
- Estheticians
- Electrologists (Mississippi only)
- Podiatrists (Nevada only)
When the injection is administered by a non-physician clinician, some states have additional requirements, such as physician supervision, a physician-prescribed treatment plan, or specific aesthetic training, certification, or permit.
In the event of an audit or legal claim, make sure your med spa can provide proof it followed the rules.
A specialty-specific software platform automatically documents who saw a patient, when, and what was discussed.
Nextech’s med spa solution keeps all a patient’s medical records and consents in one place, so clinicians, administrators, and auditors can all find exactly what they need.
State by State: Who Can Administer Aesthetic Injections (2026)
Who can perform injectable neuromodulators and fillers differs from state to state. To help you determine who in your med spa or medical practice can perform injectable neuromodulators and fillers, we gathered the most up-to-date, state-specific regulations and laws. (Note: This blog post is for general informational purposes only and is not legal advice.)
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
See also: who can legally own med spas and med spa laws by state.
Alabama
|
Who can perform injectable neuromodulators and fillers? |
In Alabama, licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Arizona, licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In California, oral surgeons can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
NPs, PAs, and licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Connecticut, licensed healthcare providers can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
LPNs, RNs, physicians, and NPs can perform injectable neuromodulators 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, injectable neuromodulators or fillers must be prescribed by a physician with prescribing capabilities. |
Florida
|
Who can perform injectable neuromodulators and fillers? |
In Florida, licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians and dentists can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Hawaii, licensed physicians or PAs can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Illinois, RNs, NPs, PAs, and physicians can perform injectable neuromodulators 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 injectable neuromodulators or dermal fillers are performed in Illinois. |
Indiana
|
Who can perform injectable neuromodulators and fillers? |
Licensed physicians or nurse practitioners can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Iowa, licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Medical professionals holding a DO, DDS, DMD, NP, or MD license can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Kentucky, any licensed medical professional can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed practical nurses, RNs, PAs, NPs, and physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Maine, PAs, nurses, and licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Massachusetts, licensed medical professionals can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Minnesota, licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Missouri, professionals who hold a DO, DDS, DMD, MD, or NP can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Nebraska, licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians, dentists, podiatrists, PAs, NPs, and RNs can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In New Hampshire, licensed physicians, NPs, RNs, and PAs can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In New Mexico, dentists, physicians, PAs, RNs, and NPs can perform injectable neuromodulators and fillers. |
|
Training requirements beyond certification? |
In New Mexico, qualified medical professionals must complete 16 hours of training specific to dermal fillers and injectable neuromodulators. |
|
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 injectable neuromodulators and fillers? |
Any medical professionals licensed by the state can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In North Carolina, physicians, PAs, RNs, and NPs can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Ohio, physicians, dentists, PAs, RNs, and NPs can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Oregon, licensed medical professionals can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed medical professionals can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Rhode Island, RNs, LPNs, PAs, physicians, and dentists can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In South Dakota, licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Qualified healthcare or allied health professionals can perform injectable neuromodulators 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, injectable neuromodulators and fillers can be performed anywhere, including in homes, but the setting must meet certain sanitary standards. |
Texas
|
Who can perform injectable neuromodulators and fillers? |
In Texas, any licensed medical professional can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Vermont, any licensed medical professional can perform injectable neuromodulators 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 injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians and physician’s assistants can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Washington, licensed physicians can perform injectable neuromodulators and fillers. |
|
Training requirements beyond certification? |
In Washington, physicians must be trained in nonsurgical aesthetic procedures before performing injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
In Wisconsin, physicians, PAs, and APRNs can perform injectable neuromodulators 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 injectable neuromodulators and fillers? |
Licensed physicians, physician’s assistants, and nurse practitioners can perform injectable neuromodulators 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. |
Limits to Injectable Neuromodulator Dosage and Dermal Filler Treatments
In 2026, no state has legally capped the allowed dosage of injectable neuromodulators or the number of aesthetic injections a patient can have.
Dosage is regulated by FDA labeling for specific treatments, manufacturer recommendations, the standard of care decided on by the clinician, and payer policies.
FDA-Approved Neuromodulator Dosage Maximums for On-Label Use
According to the FDA label, these are the dosage maximums for each of the five approved injectable neuromodulators.
The label only covers the approved treatment site; the FDA doesn’t offer guidance for off-label use like treating neck wrinkles or laugh lines.
OnabotuliniumtoxinA
| Treatment Site | Max. Dosage |
| Glabellar lines | 4 units at each of 5 sites (20 units total) |
| Crow’s feet | 4 units at each of 6 sites (24 units total) |
| Forehead and glabella together | 20 units at each of 2 sites (40 units total) |
| Maximum cumulative dosage in any 3-month interval | 400 total units |
AbobotulinumtoxinA
| Treatment Site | Max. Dosage |
| Glabellar lines | 50 units per treatment session |
IncobotulinumtoxinA
| Treatment Site | Max. Dosage |
| Glabellar lines | 4 units at each of 5 sites (20 units total) |
| Crow’s feet | 4 units at each of 6 sites (24 units total) |
| Forehead and glabella together | 20 units at each of 2 sites (40 units total) |
| Maximum cumulative dosage | 64 units per treatment session |
PrabotulinumtoxinA-xvfs
| Treatment Site | Max. Dosage |
| Glabellar lines | 20 units per treatment session |
| Minimum time between sessions | 3 months |
DaxibotulinumtoxinA-lanm
| Treatment Site | Max. Dosage |
| Glabellar lines | 40 units per treatment session |
Reimbursement Limits for Aesthetic Injections
Some insurers and state Medicaid programs cap the dosage and the number of neuromodulator or filler injections they will cover.
These are not legal caps, just caps to reimbursement. Your spa can exceed them, but the patient will have to pay for the additional dosage or treatments out of pocket.
It’s up to your clinical team to decide how much is too much. To deliver the best patient outcomes, invest in a software platform that shows at a glance what injectable treatments your patient has had (even at practices other than your med spa), how much was injected, and when.
Nextech’s one-screen chart shows all the information you need on a single screen, so clinicians don’t have to waste time during a patient appointment clicking between tabs to find the information they want.
Technological Advances in Administering Injectables
New technologies are making it easier to implant fillers or injectable neuromodulators and create a more natural look. One of the most common technologies the FDA-approved hyaluronic acid-based gel implant/dermal filler mentioned above.
AI and virtual reality are also transforming aesthetic procedure outcomes. AI, for example, can improve filler and injectable neuromodulators 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 injectable neuromodulators and dermal fillers, you could be liable if something goes wrong. Liability requirements differ from state to state. Plus, fraudulent 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.
A Med Spa Management Platform That Helps You Sell
Nextech’s intelligent med spa management software offers a range of tools to help you deliver outstanding care efficiently while growing revenue and building your practice.
Tools include TouchMD, the aesthetic industry’s preeminent interactive visualization, education, and patient communication platform.
TouchMD helps you educate patients and manage their expectations. It showcases their transformation with beautiful clinical photography, stores consent forms electronically, enables remote telehealth consultations, and includes built-in marketing features.
See how Nextech can help your med spa grow. Request a demo today.
Angela Myers, a health and health tech writer with bylines in Forbes, AARP, and others, contributed to this blog post.
See also:
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