IV Therapy Laws by State (2026)
Look up your state's IV therapy rules: whether a nurse practitioner can order and run it independently, who can start the IV and push the medications, and the good-faith-exam rule, on top of the realities that apply everywhere. For med spa, IV hydration, and wellness-drip operators.
Compiled by Silver Taza. Last checked July 2026. General information, not legal advice.
What is true in every state
- IV therapy is the practice of medicine
- A drip is a prescription-strength medical treatment. A valid order from a physician, NP, or PA, after a good-faith exam, is required before any IV is started, in every state.
- Someone qualified examines and orders first
- A client cannot simply pick a drip off a menu. An authorized provider has to evaluate them and order the specific therapy; that order is what makes it legal for a nurse to administer.
- Estheticians and unlicensed staff do not push IV meds
- Starting an IV and pushing medications is nursing and medical scope. Estheticians, cosmetologists, and, in general, medical assistants cannot order IV therapy or administer IV-push medications.
- The treating license governs, not the spa's name
- Who may order and who may push, and how closely a physician must oversee, is where states differ most. The license of the person treating decides what is legal, not the business's branding.
IV-therapy regulation changes and turns on your exact staffing, the medications used, and your setup. Confirm the current rules with your state medical and nursing boards and a healthcare attorney before you open or change how you operate.
IV therapy rules in all 50 states and DC
A nurse practitioner can order IV therapy without a physician in 28 of the 50 states and DC, and needs a collaborating or supervising physician in 22. In Wisconsin, it depends on whether the NP qualifies under a new law. A registered nurse can start the IV under a valid order everywhere; the LPN rules are where states split.
The Source column names the board document or rule behind each row. The "Who can order" column follows the AANP practice-authority map unless the row cites the state's own NP rule. Where a row cites only the AANP map or an NP rule, we found no board document on LPN IV scope for that state, so the LPN entry is a cautious default: plan on an RN.
| State | Who can order | Who can start the IV | Good-faith exam | Notes | Source |
|---|---|---|---|---|---|
| Alabama | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | Alabama's medical board ruled in 2022 that retail IV therapy is the practice of medicine: a physician, PA or CRNP must personally evaluate the patient, in person or by telemedicine, and standing orders don't satisfy that duty. CRNPs work under a collaboration agreement with a physician. An LPN can give IV push drugs only under a board-approved standardized procedure, with an RN physically present. | |
| Alaska | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority. Alaska's board lets an LPN start an IV only after proper IV education, and bars LPN IV push other than a saline flush. | |
| Arizona | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority. Board of Nursing advisory opinion covers IV hydration; RN administers under a valid order. | |
| Arkansas | NP or PA with a physician | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive Reduced-practice NP needs a collaborating physician. Medical Board Rule 2.8 lets a provider set up the patient relationship either with an in-person exam or, for non-controlled drugs such as IV fluids, by telemedicine with access to the patient's health record. The nursing board's guidelines let a trained LPN give IV push drugs that don't need an RN's specialized judgment, and its draft IV hydration statement (26-1) would require RN or provider supervision of LPNs. | |
| California | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | A California NP can drop standardized procedures after a three-year transition, but only in settings where physicians practice alongside them. Practicing outside those settings, such as a med spa with no physician on staff, takes three more years and a separate certificate. An LVN can start IV fluids after a board-approved course, under standardized procedures in an organized health care system; the statute doesn't authorize LVN IV push. | |
| Colorado | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority. Colorado's LPN IV rule lets a trained LPN run plain IV fluids and premixed fluids with electrolytes and vitamins, but bars other IV medications and any IV push of five minutes or less. | |
| Connecticut | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | An APRN who has practiced in collaboration with a physician for at least three years and 2,000 hours can then practice alone. We found no Connecticut board document on LPN IV therapy, so plan on an RN. | |
| Delaware | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority. Delaware's nursing rules let an LPN start peripheral IVs and add medications to IV solutions under supervision, but list IV push only among RN functions. | |
| District of Columbia | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive NP has full practice authority. DC lets an LPN who has completed an approved course insert short peripheral IVs and give approved IV medications under RN supervision, with an RN present in the facility during infusion therapy, and never in home care settings. | |
| Florida | NP or PA with a physician | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive Florida's autonomous APRN registration covers primary care only, so a med-spa or IV NP still needs a physician. An IV-certified LPN can give IV therapy under the direction of an RN or practitioner, who doesn't always have to be on site, if the employer approves. Blood products, chemotherapy, plasma expanders and investigational drugs need direct supervision. | |
| Georgia | NP or PA with a physician | Varies / board check needed | Required, format unsettled | Status in flux Restricted NP: needs a supervising physician (protocol). The Board of Nursing has an IV hydration position statement. Whether the good-faith exam can happen by telehealth is unsettled for 2026 as the medical board tightens its rules. | |
| Hawaii | NP on their own | Varies / board check needed | Required, telehealth OK | Status in flux NP has full practice authority. Hawaii's board has only informal views, recorded in its minutes: in 2021, that an APRN can run IV hydration after their own assessment and diagnosis, and that a trained LPN can start an IV; in 2023, that adding vitamins to an IV bag is compounding, which RNs have no authority to do. | |
| Idaho | NP on their own | Varies / board check needed | Required, telehealth OK | Status in flux NP has full practice authority. Idaho's nursing rules have no IV task list; each nurse judges scope with the board's decision-making model, so confirm LPN IV push with the board. | |
| Illinois | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | Illinois's 2025 med-spa memo says an APRN with full practice authority can practice without a written collaborative agreement; APRNs without it need one. We found no Illinois board document on LPN IV push, so plan on an RN. | |
| Indiana | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | An Indiana NP needs a written practice agreement with a collaborating practitioner to prescribe. We found no Indiana board document on LPN IV push, so plan on an RN. | |
| Iowa | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority. Iowa bars RNs from delegating IV push to LPNs and allows LPN IV therapy only in hospitals, nursing facilities and dialysis units, so an IV bar needs an RN. | |
| Kansas | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive NP has full practice authority, but Kansas issued a 2026 retail-IV warning: the prescriber must personally evaluate the patient and write a patient-specific order; menu/standing-order models and compounding are high-risk. IV-qualified LPN scope is facility-policy and drug-category limited. | |
| Kentucky | NP or PA with a physician | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive Reduced-practice NP needs a collaborative agreement to prescribe. An LPN doing infusion therapy works under the direction and supervision of an RN, APRN, PA, physician or dentist, and the supervisor has to be physically nearby and immediately available if the patient is or becomes unstable. | |
| Louisiana | NP or PA with a physician | RN; LPN only with required training/supervision | Required, telehealth OK | Reduced-practice NP needs a collaborating physician. Louisiana LPNs with IV certification may initiate IVs and give IV-push meds. | |
| Maine | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | Status in flux NP has full practice authority. Maine's nursing board published a statement on IV therapy clinics that allowed LPN peripheral IV-fluid work only after facility training and under RN supervision, but it's no longer on the board's site and we couldn't confirm it still stands. Plan on an RN and check with the board. | |
| Maryland | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority. Maryland lets an LPN insert peripheral IVs and give some IV medications with an RN on site or reachable by phone, but bars LPN IV push outside hemodialysis. | |
| Massachusetts | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive NP has full practice authority. Massachusetts lets a competent LPN, under facility policy, insert short and midline peripheral IVs and give medication or hydration through an existing line. The board says IV hydration in a mobile unit or wellness clinic has to meet the same standards as anywhere else, and an RN or prescriber has to do the patient assessment. | |
| Michigan | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | Restricted NP: needs physician supervision/delegation for this context. RN administers under a valid order. | |
| Minnesota | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | A Minnesota NP practices independently after 2,080 hours under a collaborative agreement. We found no Minnesota board document on LPN IV push, so plan on an RN. | |
| Mississippi | NP or PA with a physician | RN; LPN only with required training/supervision | Required, format unsettled | Status in flux Reduced-practice NP needs a collaborating physician. The medical board's 2023 guidance says IV hydration is the practice of medicine and standing orders are unlawful. The nursing board's 2025 statement requires an individualized order and a completed history and physical by a physician, NP or PA, which is hard to do over video. LPNs may help give IV hydration and medications only under RN or provider supervision. | |
| Missouri | NP or PA with a physician | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive Restricted NP: needs a collaborative practice arrangement with a physician. An IV-certified LPN can give IV push or bolus drugs under the direction and supervision of an RN or prescriber, but can't add drugs to the bag of a running IV. | |
| Montana | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive NP has full practice authority. Montana lets an LPN who has completed IV training start peripheral IVs, give most IV medications, and push a short list of drug classes, including analgesics, antiemetics and corticosteroids, under appropriate supervision. | |
| Nebraska | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority. Board of Nursing advisory opinion covers IV/infusion therapy; RN administers under a valid order. | |
| Nevada | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive NP has full practice authority. The Nevada nursing board's practice decision, re-approved in March 2025, lets an RN, or an LPN who meets the state's IV certification rules, give IV solutions and medications outside a hospital, on an order from a practitioner who assessed the patient first. | |
| New Hampshire | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority and may order IV therapy independently. RN administers under the order. | |
| New Jersey | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | Reduced-practice NP needs a collaborating physician (joint protocols). We couldn't open a New Jersey board document on LPN IV push, so plan on an RN. | |
| New Mexico | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive NP has full practice authority, but New Mexico's IV-therapy policy requires a compliant telemedicine evaluation by a licensed prescriber before treatment, clinical-necessity ordering, appropriate medical supervision, continuous monitoring, and verified training/licensure for delegated staff. | |
| New York | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority after the transition period. New York bars LPNs from giving any drug by IV push other than flushes, and LPN IV therapy needs on-site supervision by an RN, NP, physician or other listed practitioner. | |
| North Carolina | NP or PA with a physician | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive Restricted NP: needs a supervising physician. Board position statements allow LPN participation only under appropriate supervision; the LPN requires continuous availability of an RN who can be on site when necessary. RN-administered is the safer default for an unsupervised IV-bar model. | |
| North Dakota | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive NP has full practice authority. North Dakota lets an LPN who completed a board-approved IV course start peripheral IVs and give selected IV bolus drugs set by facility policy, under the supervision of an RN, APRN or licensed practitioner, for stable patients. | |
| Ohio | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | Status in flux Reduced-practice NP needs a collaboration agreement. Ohio's medical, nursing and pharmacy boards issued a joint statement on retail IV clinics in May 2025: standing orders can't replace a prescriber's decision, and pharmacy licensing (TDDD) and compounding rules apply. | |
| Oklahoma | NP or PA with a physician | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive Restricted NP: needs physician supervision. Oklahoma's board says IV medication administration can be within an LPN's scope with training and RN supervision; the employer's policy has to list which drugs the LPN may give by IV push. | |
| Oregon | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive An APRN with prescriptive authority can prescribe IV hydration after working through the board's scope-of-practice algorithm. An LPN can take part in IV hydration under clinical direction, and only after checking the board's scope criteria. No patient can pick a drip off a menu. | |
| Pennsylvania | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | Reduced-practice NP needs a collaborative agreement. Pennsylvania bars LPNs from giving medications by IV push or bolus. | |
| Rhode Island | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | Rhode Island lets an APRN practice without a collaborative agreement. We couldn't open a Rhode Island board document on LPN IV push, so plan on an RN. | |
| South Carolina | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | South Carolina's medical, pharmacy and nursing boards said in 2023 that LPNs may not take part in retail IV hydration at all. A physician, PA or APRN has to evaluate the patient personally, which can be by telemedicine, and an APRN's collaborative agreement has to cover retail IV hydration. | |
| South Dakota | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority. South Dakota lets an LPN give peripheral IV push drugs only under direct supervision and only in a licensed health care facility, which most IV bars aren't. | |
| Tennessee | NP or PA with a physician | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive Restricted NP: needs physician supervision/chart review. Tennessee allows selected LPN IV-push medications only under physician, dentist, or RN supervision, in peripheral lines, for adults over 80 pounds, after required IV-push training; several drug classes are barred. | |
| Texas | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | Status in flux Restricted NP: needs a physician (prescriptive-authority agreement); Texas doesn't recognize independent NP practice. | |
| Utah | NP on their own | RN for IV push (LPN limited) | Required, telehealth OK | NP has full practice authority and may order IV therapy independently. RN administers under the order. | |
| Vermont | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive NP has full practice authority. Vermont's 2024 joint statement says an LPN needs validated competency and direct supervision to give IV fluids, may never mix additives into IV saline (that's compounding), and that clinic standing orders aren't valid prescriptions. | |
| Virginia | NP or PA with a physician | Varies / board check needed | Required, telehealth OK | Status in flux A Virginia NP with under three years of clinical experience needs a practice agreement with a physician; after that, autonomous practice is possible. We found no board guidance on LPN IV push in a retail IV setting, so plan on an RN and check with the Board of Nursing. | |
| Washington | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive NP has full practice authority, but the Board frames LPN infusion tasks as dependent on competence, training, an authorized practitioner order, and either practitioner direction or RN direction/supervision. It should not be read as permission for an unsupervised LPN-run IV bar. | |
| West Virginia | NP or PA with a physician | RN for IV push (LPN limited) | Required, telehealth OK | A West Virginia APRN needs a collaborative agreement to prescribe unless the board has approved removing it. We found no West Virginia board document on LPN IV push, so plan on an RN. | |
| Wisconsin | Depends on the NP | RN; LPN only with required training/supervision | Required, telehealth OK | Status in flux Since September 1, 2026, a Wisconsin APRN who meets Act 17's requirements can practice without a collaborating physician; others still need one. The boards' October 2025 guidance says an LPN may give ordered IV hydration, but an RN has to do the nursing assessment and monitor the patient. Standing orders are allowed only after an individualized assessment. | |
| Wyoming | NP on their own | RN; LPN only with required training/supervision | Required, telehealth OK | Setup-sensitive APRNs practice independently. Wyoming lets an IV-certified LPN start a short peripheral line and give IV antibiotics by push, but not the first dose, and bars LPNs from giving electrolytes such as potassium or magnesium. The boards' retail IV statement requires an audio/video visit to set up the patient relationship; a form alone won't do. |
"Status in flux" means the board has no clean answer for a retail IV setup, or sources disagree. "Setup-sensitive" means an LPN can do some IV work, but only with the training, supervision, and facility policy the board describes, which rules out an LPN running an IV bar alone. "Telehealth OK" means we found no rule requiring the first exam in person.
IV therapy is a medical service, wherever you offer it
A vitamin drip looks like wellness, but legally it is the practice of medicine: prescription-strength fluids and medications delivered into a vein. That means the same frame applies in every state. An authorized provider, a physician, nurse practitioner, or PA, has to examine the client and order the specific therapy, and a nurse administers it under that order. A client cannot pick a drip off a menu, and unlicensed staff cannot start the line.
What changes from state to state is who can play each role, which is what the lookup and the table above are for.
The two questions that decide how you staff it
The first is whether a nurse practitioner can order and direct IV therapy on their own. In a full-practice-authority state they can, which is why so many IV businesses are NP-run. In the rest, a nurse practitioner or PA needs a collaborating or supervising physician, and you have to build that relationship into the business rather than bolt it on later.
The second is who can start the IV. A registered nurse can, under the order, in every state. Whether a licensed practical nurse can start IVs and push IV medications is where states differ, and it changes who you can hire for the chair. The table marks both, and flags the states where the rules are unsettled instead of guessing.
How this fits with the rest of your med-spa compliance
IV therapy sits inside the wider question of who can own and run a medical aesthetic practice in your state. If you also offer injectables, lasers, or memberships, the ownership, medical-director, and injection rules matter just as much as the IV rules.
This page covers IV therapy only. Confirm the ownership and medical-director rules, along with the IV rules, with your state medical and nursing boards and a healthcare attorney before you open or restructure.
Frequently asked questions
Who can administer IV therapy in a med spa?
A registered nurse can start the IV and push the medications under a valid provider order in essentially every state. Whether a licensed practical nurse (LPN or LVN) can start IVs and push IV medications is where states differ, from South Carolina, which keeps LPNs out of retail IV hydration entirely, to Montana, which lets a trained LPN push some drug classes. The table marks each state. Estheticians, cosmetologists, and, in general, medical assistants cannot start an IV or push IV medications anywhere; it is nursing and medical scope.
Do you need a doctor to run an IV therapy business?
It depends on your state's nurse practitioner rules. In a full-practice-authority state, a nurse practitioner can order IV therapy, do the good-faith exam, and direct the service on their own, and many IV businesses there are NP-run. In a physician-directed state, a nurse practitioner or PA needs a collaborating or supervising physician, so you have to build that oversight into the business. The lookup shows which applies in your state.
Is a good-faith exam required before IV therapy?
Yes, essentially everywhere. IV therapy is a medical treatment, so an authorized provider, a physician, nurse practitioner, or PA, has to evaluate the client and order the specific therapy before a nurse administers it. A client cannot simply pick a drip off a menu. Most states allow that exam by telehealth, some with conditions, such as Wyoming's requirement for a live audio/video visit. In Georgia and Mississippi it's unsettled whether the exam can be remote, and the table notes each state.
Can an esthetician give IV drips?
No. Starting an IV and pushing medications is outside an esthetician's or cosmetologist's scope in every state. IV therapy is administered by a registered nurse, or where allowed a licensed practical nurse, acting on an order from a physician, nurse practitioner, or PA. This is the single most common way IV-therapy setups run into trouble, so the license of the person treating matters more than anything else.
Sources
Each state's board document is linked in the table above. These apply across states:
- AANP: State Practice Environment . The nurse-practitioner practice-authority map (full, reduced, restricted). The 'Who can order' column follows it, except Wisconsin, whose new APRN law took effect September 1, 2026.