Who can inject Botox in Georgia?

Last checked October 25, 2026 against the sources listed below. Information, not legal advice: confirm with the board before you treat patients.

In Georgia, physicians can inject Botox and dermal fillers. Nurse practitioners and physician assistants can inject when their Medical Board-approved nurse protocol agreement or job description covers it. Registered nurses can inject only on an individualized order after a physician, NP or PA has done a history and physical; standing orders do not count. LPNs and estheticians cannot perform cosmetic injections, and no Georgia rule or board statement addresses medical assistants giving them.

Who can inject in Georgia: role by role

Role	Botox (neurotoxins)	Dermal fillers	Conditions
Physician (MD/DO)	Yes	Yes	Active Georgia license. The physician stays responsible for acts delegated to NPs and PAs.
Physician assistant	Yes, with conditions	Yes, with conditions	Only tasks in the PA's Board-approved job description, within the supervising physician's own scope. Acts not covered by the Board's standard job description need express Board approval, and Medical Board minutes show it approving Botox and filler injections as PA "additional duties." The physician must be available for immediate consultation, which can be by phone. Tasks outside the job description need the physician present.
Nurse practitioner (APRN)	Yes, with conditions	Yes, with conditions	Written nurse protocol agreement with a delegating physician, filed with the Medical Board. The physician's specialty must be comparable, and the Board says the delegated services should be ones the physician regularly does in their own practice. Procedures outside the NP's certification specialty need a separate Form C for each one; the Board routinely approves Form Cs for neurotoxins and fillers. The physician must be available for immediate consultation, observe the NP on-site at least once a year and review records every three months.
Registered nurse	Yes, with conditions	Yes, with conditions	Individualized order from a physician, NP or PA with prescriptive authority, plus a history and physical by that prescriber, before treatment. No standing orders. The RN needs documented competency and may not diagnose or plan treatment.
LPN/LVN	No	No	The Board of Nursing says neuromodulator and dermal filler injections are outside LPN scope.
Medical assistant	Not addressed	Not addressed	No board statement found on cosmetic injections by MAs. Georgia lets physicians delegate subcutaneous and intramuscular injections to MAs with a physician, or a PA or NP under their job description or protocol, on-site. The Medical Board rule also says delegating work to someone not authorized to do it counts as unlicensed practice. In 2026 the Medical Board said MAs may not perform microneedling; it has not said whether MAs may give Botox or fillers.
Esthetician	No	No	The esthetician license does not cover injections. Georgia's esthetics definition excludes "medical aesthetics," and the Medical Board's rules list injection of fillers and neurotoxins as medical and surgical procedures. Botox is a prescription-only drug under Georgia law.

Dentists are a separate case. A Georgia dentist may inject neurotoxins and fillers in the gums, cheeks, jaws, lips and mouth area, in connection with a dental procedure in a dental setting, after a Board-approved course of at least 21 hours (oral surgeons are exempt). The dentist may not delegate the injection.

The patient exam before treatment

Before an RN injects, a physician, NP or PA with prescriptive authority must do a history and physical and write an individualized order for that patient. The Board of Nursing says standing orders are "not an appropriate substitute." If clients walk in on their own, the nurse is responsible for checking that both the order and the prescriber's exam exist before treating. The Board has not published its own definition of "standing orders" for this statement.

Georgia's rules do not use the term "good faith exam," and no rule says how often the exam must be repeated. No cosmetic-specific rule requires the exam to be in person. The Medical Board's general telehealth rule allows care by electronic means when, among other conditions, the provider has the patient's history and can examine the patient with technology "equal or superior" to an in-person exam. The provider must also make diligent efforts to have the patient seen in person at least once a year.

Supervision and delegation

NPs: work under a nurse protocol agreement. The delegating physician must be available for immediate consultation, which can be by phone. The physician must document on-site observation of the NP at least once a year and review records every three months. The agreement is reviewed every year.
PAs: work under a Board-approved job description. For tasks in that job description, the supervising physician does not need to be in the building if immediate consultation is available. For anything outside it, the physician must be present.
RNs: act on an individualized order from a physician, NP or PA. The Board of Nursing statement does not set an on-site supervision rule for cosmetic injections, but the RN cannot diagnose or create treatment plans.
Ratios: since 2024, a physician may have protocols or job descriptions with up to the combined equivalent of eight NPs or PAs at one time. The listed exceptions (hospitals, public health, free and federally funded clinics and similar settings) do not include med spas.
Medical assistants: if a practice uses MAs for any injections, a physician, or a PA or NP under their job description or protocol, must be on-site.

Med spa ownership and the medical director

We found no Georgia med spa license and no statute or rule that creates a "medical director" role for med spas. The Medical Board defines "medispa" only in its office sedation rules, which apply when moderate or deeper sedation is used, not to routine Botox or filler visits. In 2011 an assistant attorney general told the Medical Board that Georgia's ban on the corporate practice of medicine "was never codified" and that the Board had never disciplined anyone for it.

The real limits come from the supervision laws. A physician may not be an employee of the NP they supervise, except in certain listed settings. A physician also may not be an employee of the PA they supervise unless the Board approved the arrangement before July 1, 2009.

In a position statement dated May 7, 2026, the Medical Board said it reads the NP rule to cover a physician receiving "compensation of any kind" from an NP or an NP-owned company for serving as the delegating physician, including payments routed through physician-matching services. For PAs, it said the supervising relationship must be real, not nominal. On May 26 the Board called the statement preliminary. On June 4 it said the statement was not meant to create new law or policy and reflects its longstanding interpretation. It also said it is not telling anyone to close a practice, is not ending active protocols, and will closely examine physician relationships when it approves protocols or takes enforcement action. The Board did not withdraw the statement. July 2026 minutes record a further discussion with physician and APRN groups. As of October 25, 2026, we found no revised statement or new rule, and the May statement and the follow-up notices are still posted on the Board's website.

Under the Board's stated reading, an NP-owned injectables business that pays its delegating physician, directly or through a matching service, is an arrangement the Board says is not permitted. The May statement also says all licensees must tell the public who the delegating or supervising physician is and how to reach them. The Board of Nursing has referred complaints to the Medical Board to check whether a medical director was letting an RN practice cosmetic medicine.

Training and certification

We found no Georgia certificate or course requirement for physicians, PAs, NPs or RNs who inject. Instead, the Board of Nursing requires nurses to have documented knowledge, skill and competency for the procedure, and businesses must keep on-site policies for cosmetic procedures and emergencies. NPs need the procedure in their protocol (with a Form C if it is outside their certification specialty), and PAs need it in their approved job description. Dentists must complete a Board-approved course of at least 21 hours.

Recent changes

March 2024: the Board of Nursing issued its Cosmetic/Aesthetic Procedures position statement: RN yes with an individualized order and prescriber exam, LPN no, no standing orders. Board minutes from 2024 and 2025 show it sending the statement to nurses in complaint cases.
2024: HB 1046 replaced the separate limits of four NPs and four PAs per physician with a combined limit of eight.
2024: HB 557 let a new NP protocol that is substantially similar to an approved one be deemed valid on submission, subject to Board review.
2024: HB 502 expanded Georgia's cosmetic laser law to energy-based devices; this affects lasers and body contouring, not injections.
May 25, 2026: updated Medical Board rules for NP protocols, PAs and cosmetic lasers took effect, matching those 2024 laws.
May and June 2026: the Medical Board's position statement on physician supervision and IV therapy, a notice calling it preliminary, and a June statement saying it is not new law. No later revision found as of October 25, 2026.

FAQ

Can an RN inject Botox in Georgia under standing orders?

No. The Board of Nursing requires an individualized order and a history and physical by a physician, NP or PA for each patient, and says standing orders are not a substitute.

Can an LPN inject Botox or fillers in Georgia?

No. The Board of Nursing says cosmetic and aesthetic procedures, defined as neuromodulator and dermal filler injections, are outside LPN scope.

Can an RN open her own injection business in Georgia?

The Board of Nursing allows RNs to form an independent nursing business, but every injection still needs an individualized order and an exam by a physician, NP or PA. The RN cannot diagnose or plan treatment, so a prescriber must be part of every patient's care.

Can a nurse practitioner own a med spa and pay a collaborating physician?

Georgia law says a physician may not be the employee of the NP they supervise, and in May 2026 the Medical Board said it reads this to cover any payment from the NP or the NP's company for serving as the delegating physician. In June the Board said it is not ending active protocols but will closely examine these relationships, and it has not withdrawn that reading. NP owners should have their structure reviewed by Georgia counsel.

Does the exam before treatment have to be in person?

No Georgia rule specific to cosmetic injections says so. The Medical Board's general telehealth rule allows remote care when the provider can examine the patient with technology equal or superior to an in-person exam, and asks for diligent efforts to see the patient in person at least once a year.

Sources

Rules change and boards interpret them case by case. If your situation is unusual, ask the Georgia board or a health care attorney.

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