Who Can Inject Botox in Kansas? Healing Arts and Nursing

Three Kansas boards cover the people you are most likely to meet at a med spa. The Kansas State Board of Healing Arts runs the licensee search for medical doctors, osteopathic doctors and physician assistants, among other professions. The Kansas State Board of Nursing takes complaints about APRNs, RNs, LPNs and LMHTs. The State Board of Cosmetology licenses people who practice under article 19 of chapter 65, which contains the esthetician definition in K.S.A. 65-1901, and runs its own license search.

None of the Kansas statutes, regulations or board guidance we reviewed names Botox, neurotoxins or dermal fillers as a treatment a particular license may or may not perform. What they set out is who practices medicine, how a licensed physician may delegate, and what each license covers. The table summarizes them; the sections below explain each one.

This guide covers Kansas sources only. If you are booking in Kansas City, Missouri, read our Missouri injector guide. If you are comparing Wichita med spas, use this guide to prepare questions, not to approve a clinic's staffing.

For the purpose of the healing arts act, K.S.A. 65-2869 deems people who prescribe, recommend or furnish medicine or drugs, or perform any surgical operation by the use of any surgical instrument, procedure, equipment or mechanical device, for the diagnosis, cure or relief of any wounds, fractures, bodily injury, infirmity, disease, physical or mental illness or psychological disorder, to be engaged in the practice of medicine and surgery. The statute does not mention cosmetic treatments.

K.S.A. 65-2872 lists people who are not practicing the healing arts. They include people whose professional services are performed under the supervision or by order of or referral from a practitioner licensed under the healing arts act, nurses licensed and practicing under and in accordance with article 11 of chapter 65 of the Kansas statutes, and people licensed by the Board of Cosmetology practicing under and in accordance with article 19 of that chapter. The statute adds that every act or practice in the field of the healing arts that it does not specifically except is the practice of the healing arts.

K.S.A. 65-28,127 sets conditions for a licensee who supervises, orders or delegates acts that are the practice of the healing arts. The licensee must be actively engaged in the practice of the healing arts in Kansas; review and keep current any required written agreements or practice protocols; delegate only acts the licensee knows or has reason to believe the person can competently perform and that are not in violation of any other statute or regulation; delegate only acts within the licensee's own normal and customary specialty, competence and lawful practice; provide a qualified substitute licensee when temporarily absent; and comply with the board's rules on limits and conditions for delegation and supervision. The statute defines a responsible licensee as a person the Board of Healing Arts licenses to practice medicine and surgery or chiropractic, and says the physician assistant licensure act governs physicians' supervision of physician assistants, except as board rules provide otherwise.

The statute lets the Board of Healing Arts adopt rules on delegation and supervision. The one such rule we reviewed, on lasers and other light-based devices, is described below. None of these statutes names Botox, neurotoxins or dermal fillers, and none sets an on-site requirement for injections.

The Board of Healing Arts' Office of the General Counsel publishes FAQs, including one on medical spas. Asked whether a non-physician may open a medical spa planning to hire physicians or to delegate medical services to non-physician staff, it answers that any business offering medical services can only be owned by a physician, or co-owned by the physician with other specified licensed professionals. It says a person who is not licensed to practice medicine may not open a business that offers medical services, that a violation is a felony, and cites K.S.A. 65-2867. It adds that Kansas physicians may face disciplinary action for fee-splitting with unlicensed individuals or entities.

These FAQs are not rules. Each page says its statements "are intended as general guidance to hypothetical questions and do not necessarily represent the position of the Board," and that information on the board's website is general guidance, not legal advice. The statute the FAQ cites, K.S.A. 65-2867, makes it unlawful for a person not licensed under the healing arts act to open or maintain an office for the practice of the healing arts, and makes a violation a severity level 10, nonperson felony.

The general counsel's corporations FAQ says Kansas prohibits the corporate practice of medicine: a general business entity may not engage in a learned profession such as medicine through employment of or contract with a licensed professional. It names exceptions for an entity otherwise permitted by state statute to engage in the profession and for a professional corporation or limited liability company wholly owned by licensed professionals, and notes that a hospital may employ physicians. It adds that "there are limitations upon which professions are allowed to combine into a single entity," and that a business entity not entirely owned by physicians, or other qualified persons under K.S.A. 17-2707, cannot practice medicine in Kansas or employ a Kansas physician to do so. It also says physicians often engage management companies for administrative functions, and urges licensees to get legal advice when forming a business entity.

The board's guidance documents page lists two documents: an IV hydration statement and guidelines for disciplinary sanctions. The IV statement, issued jointly with the Kansas Board of Pharmacy, says the boards have received complaints about IV therapy at IV hydration clinics, medical spas and other locations, and that it is not a legal document binding on the boards. The copy we reviewed shows no date. It concerns IV therapy and does not mention Botox. In its discussion of IV therapy it says only a person with prescriptive authority may diagnose a patient and decide to provide medication, by injection or otherwise, and that this person must personally evaluate the patient. It also says non-patient-specific standing orders issued by an IV clinic medical director are not valid prescriptions.

K.S.A. 65-1113 defines registered professional nursing to include the execution of the medical regimen as prescribed by a person licensed to practice medicine and surgery or dentistry. It defines practical nursing as performing those nursing tasks and responsibilities, based on acceptable educational preparation, within the framework of supportive and restorative care under the direction of a registered professional nurse, a physician or a dentist.

K.S.A. 65-1130 says an APRN may prescribe durable medical equipment and prescribe, procure and administer any drug consistent with the APRN's specific role and population focus, except that an APRN may not prescribe a drug intended to cause an abortion, and controlled substances must be handled under the uniform controlled substances act. Separate provisions govern drugs for nurse anesthetists functioning in that role and for nurse-midwives in independent practice. The Board of Nursing establishes APRN roles by rule. The statute does not mention cosmetic treatments.

On the Board of Nursing pages we reviewed, we found no position statement, advisory opinion or rule on cosmetic or aesthetic procedures. The closest document is a meeting record, not a rule: minutes of the board's Practice Committee meeting of March 21, 2023, approved June 13, 2023. They record: "Many of the practice questions received concern medical spas, IV hydration clinics, and botox. KSBN does not regulate businesses. KSBN issues Certificates of Verification for nurses to obtain LLCs." They add that KSBN staff would meet with general counsel about the business practice of nurses and LLCs, and, as of that March 2023 meeting: "Currently, there are no regulations surrounding IV hydration clinics, med spas, or botox." The minutes put a Nebraska Board of Nursing presentation on medical spas and botox on the June 2023 agenda; we did not review later minutes.

The board's Scope of Practice Decision Tree for the RN and LPN, a tool it says is not legal advice, asks whether an activity requires a healthcare provider's order, whether there is documentation that the nurse has completed appropriate education and demonstrated the needed knowledge, skill and ability, and, for an LPN, whether adequate RN supervision will be available.

K.S.A. 65-28a08 says physician assistants practice in a dependent role with a supervising physician and may perform acts that constitute the practice of medicine and surgery only under a physician's direction and supervision. A PA must be identified to the patient as a physician assistant before performing under that supervision. The general counsel's physician assistant FAQ, which carries the same guidance notice, adds that a PA may practice at a different location from the supervising physician if the PA has spent at least 80 hours since being licensed under the direct supervision of a physician licensed in Kansas, the location is listed on the active practice request form, and the supervising or substitute supervising physician remains available, which may be by electronic means. Written notice that the location is staffed primarily by a PA must be posted where patients are likely to see it. The FAQ also says a PA may hold no more than 49 percent of the shares of a professional corporation organized to render a physician's services, and may own all of an entity organized to render PA services, but that entity cannot employ, contract for or otherwise offer a physician's services; for example, a PA cannot own a medical practice and arrange for a physician to supervise them. Our nurse delegation guide covers the general questions.

K.S.A. 65-1901 defines an esthetician as a person who, for compensation, practices cosmetology only to the following extent: eyebrow and eyelash services; cleansing, stimulating or performing any other noninvasive beautifying process on the skin by hands or by mechanical or electrical appliances other than electric needles, for esthetic rather than medical purposes; temporary hair removal by the same means; and using cosmetic preparations, antiseptics, lotions, creams or other preparations in performing those practices. The definition does not mention injections or lasers. K.S.A. 65-2872 treats Board of Cosmetology licensees as outside the practice of the healing arts when they are licensed and practicing under and in accordance with their own article. See our esthetician scope guide.

For lasers and other light-based medical devices, the Board of Healing Arts' regulation K.A.R. 100-27-1, on supervision of light-based medical treatment, applies when a physician licensed in Kansas (an MD or DO) authorizes another person to perform a professional service using a light-based medical device. The physician must be immediately available, meaning in the same building or able to be at the location within five minutes, or have a written practice protocol signed by the physician and the person performing the treatment. A stricter tier covers a class III or class IV device, which the regulation defines as a medical instrument that is a class IIIa, class IIIb or class IV laser product, or that emits radiation in a continuous wave of more than one milliwatt or at a pulsed rate of more than five milliwatts, and an intense pulsed-light device substantially equivalent to a laser surgical device. For those, the physician must be physically present, meaning in the same office within the building and capable of constant, direct communication throughout the service, or immediately available with a signed protocol. The regulation does not apply to phototherapy for hyperbilirubinemia in newborns, to chiropractors engaged in light-based physiotherapy, or to licensed physical or occupational therapists providing treatments as authorized by law.

A protocol is needed only when the physician is not immediately available or, for the stricter tier, not physically present. When one is used, the regulation says it must require, among other things, that the person not provide any service they are not competent to perform by training, education and experience; that you consent to the treatment after being informed of its nature and purpose, its risks and expected consequences, alternatives to light-based medical treatment, and its identification as a medical and surgical procedure; that you be told the physician's identity, emergency telephone number and, if different from where the treatment is performed, practice location; and that the physician review your record and authenticate that review within 14 days after the treatment. The regulation does not say which licenses the person performing the treatment must hold.

For physicians and physician assistants, use the Board of Healing Arts' Licensee & Registrant Profile Search. At least one field must be specified, and the board says the specialty field for MDs and DOs is self-reported and not independently verified. For nurses, the Board of Nursing says its online verification system is the primary source for nursing license status verification in Kansas, and describes Nursys QuickConfirm as a free secondary source. For an esthetician, the Board of Cosmetology's practitioner license search requires a license type. Our license verification guide covers the general steps.

The Board of Healing Arts' complaint FAQs say anyone who has knowledge of a licensee's unprofessional conduct or inability to practice within the standard of care may file a complaint, using the complaint form, by regular mail or email, or by contacting the Complaint Coordinator by phone for assistance. There is no statutory time limit, and every complaint is reviewed, even anonymous ones, though anonymity is not guaranteed. The board cannot give legal advice and only has authority concerning the licensing of the licensee.

For an APRN, RN, LPN or LMHT, the Board of Nursing's complaint page offers an online form for members of the public, one for employers and risk managers, and a paper form to mail to the board. The Board of Cosmetology's FAQ page lists questions on how to file a complaint and whether the board regulates medical spas; read the answers on the board's own page. See our complaint guide.

Write down who will evaluate you, who will prescribe or authorize the treatment, who will inject and who supervises that person. For a physician assistant, ask for the supervising physician's name. For a laser or light-based treatment, ask whether the physician will be in the building or, if not, whether a written protocol signed by the physician and the person treating you is in place. When the regulation requires a protocol, the protocol must require that you be told the physician's identity, emergency telephone number and, if different, practice location. Our consultation checklist helps organize the rest.

A directory listing or a rating does not verify an injector's scope. The state-by-state injector guide covers other states; for an appointment in Kansas, check the Kansas boards.