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-approvedgel 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
