Who may own it, and who may treat the patient.

Nurse practitioner authority

• Full — the NP may evaluate, diagnose and prescribe under the exclusive authority of the state board of nursing. 27 states on this map.
• Reduced — a career-long collaborative agreement with a physician is required for at least one element of practice. 12 states.
• Restricted — career-long supervision, delegation or team management by a physician is required. 11 states.

For an owner, this is a cost line as much as a legal one: in reduced and restricted states, the collaborating or supervising physician is a recurring expense and a single point of failure the day that physician resigns.

Practice ownership — corporate practice of medicine

• Strict — a medical practice must be physician-owned; non-physician owners structure around it with an MSO and a professional corporation. 22 states.
• Moderate — the doctrine exists but is limited, uncodified, or lightly enforced. 12 states.
• Minimal — no meaningful prohibition on non-physician ownership, though only licensees may deliver medical services. 15 states.

These labels compress a genuinely complicated body of law into one word, and several states are actively changing — a few have recently tightened the rules on management services organisations specifically. Use the label to know how hard the question is, then have a healthcare attorney licensed in that state draft the structure.

Who may inject, and the exam that comes first

These two rows travel together. The pattern in most states is that a practitioner authorised to diagnose — a physician, and depending on the state an NP or PA — must evaluate the patient and issue an order, after which a nurse may administer it. What varies is who may perform that evaluation, whether telehealth satisfies it, whether fillers are treated differently from neuromodulators, and whether the supervising practitioner must be physically present.

Several states have no cosmetic-specific board rule at all. Those rows say so. It is the honest answer, and it is also the useful one: in those states the question goes to the board in writing before you build a staffing model on an assumption.

Each state was researched against primary sources first — state board rules, position statements, statutes and administrative code — falling back to well-known secondary sources where no primary source could be located. The nurse practitioner classifications come from the American Association of Nurse Practitioners. Every line carries the source it was verified against, so you can check our work rather than take our word.

Where a field could not be confirmed, it says so. We did not infer a rule from a neighbouring state, and we did not repeat a claim we could not trace to a source. Those gaps are real gaps in published guidance, and they are worth knowing about: a state with no cosmetic-specific rule is a state where the answer comes from a board opinion letter, not from a blog.

This is not legal advice and it is not a substitute for the boards. It is a starting point built by operators who place medical directors and pharmacy relationships for clinics, so that the first conversation with your attorney starts from the right question. If a row is wrong or has gone stale, tell us at justin@eventideaw.com and we will correct it and note the date.

Cite it freely. Associations, educators and journalists are welcome to quote or link any row with attribution to this page.