50-State Regulatory Atlas Data and maps Elective IV hydration rules
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Elective IV hydration: board positions and order requirements by state (2026)
24 jurisdictions have a board position, joint statement or statute requiring a prescriber’s order for elective IV (12 also reject standing orders); 5 have guidance under board review (including drafts) or located but not read; in 21 no IV-specific guidance was found; 1 not yet researched.
Educational summary, last reviewed October 17, 2026. Not legal advice — confirm with the state licensing agency or counsel.
- Individualized prescriber exam and order; standing orders rejected 12
- Prescriber assessment and individualized order required 10
- Individualized order; written standing orders contemplated 1
- State statute: physician orders or delegates (Tex. Occ. Code ch. 172) 1
- Under board review (including drafts), or guidance located but not read 5
- No IV-specific board guidance found 21
- Not yet researched 1
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Every state
| State | Answer | Value | Verification |
|---|---|---|---|
| Alabama | Individualized prescriber exam and order; standing orders rejected | The Alabama Board of Medical Examiners’ declaratory ruling (July 21, 2022) holds that diagnosing, treating, advising on or prescribing IV fluid or med | Verified |
| Alaska | Under board review (including drafts), or guidance located but not read | Six Alaska boards, including the Board of Nursing, convened a medical spa services work group that discussed IV hydration in 2025 and planned a draft | Provisional |
| Arizona | Prescriber assessment and individualized order required | The Arizona State Board of Nursing adopted an advisory opinion, “Intravenous Hydration and Other Therapies” | Provisional |
| Arkansas | Under board review (including drafts), or guidance located but not read | Arkansas’s Board of Nursing published a draft position statement, PS 26-1, “Role of the Licensed Nurse in the Practice of IV Hydration Services” | Verified |
| California | Prescriber assessment and individualized order required | The California Board of Pharmacy’s policy statement (August 1, 2024) says IV hydration “is a medical treatment that requires an examination with an au | Verified |
| Colorado | No IV-specific board guidance found | No Colorado Board of Nursing opinion on IV hydration was found. | Provisional |
| Connecticut | No IV-specific board guidance found | No Connecticut Board of Nursing or DPH guidance on IV hydration was found. | Verified |
| Delaware | Not yet researched | Not yet researched — confirm with the Delaware board of nursing | |
| District of Columbia | No IV-specific board guidance found | No board of nursing or medical board guidance specific to IV hydration was found for the District of Columbia in the sources searched. | Provisional |
| Florida | No IV-specific board guidance found | No Florida Board of Nursing or Board of Medicine position statement on IV hydration was found. | Provisional |
| Georgia | Individualized prescriber exam and order; standing orders rejected | The Georgia Composite Medical Board’s position statement (May 7, 2026) quotes the Board of Nursing’s IV hydration statement (dated March 2024, posted | Verified |
| Hawaii | No IV-specific board guidance found | No Hawaii Board of Nursing guidance on IV hydration was found. | Provisional |
| Idaho | Under board review (including drafts), or guidance located but not read | At its June 5, 2024 meeting, Idaho’s APRN Advisory Committee raised concerns about IV hydration in various settings, directed review of Nevada’s appro | Provisional |
| Illinois | No IV-specific board guidance found | No Illinois Department of Financial and Professional Regulation statement specific to IV hydration was found. | Provisional |
| Indiana | No IV-specific board guidance found | No board of nursing or medical board guidance specific to IV hydration was found for Indiana in the sources searched. | Provisional |
| Iowa | No IV-specific board guidance found | No Iowa Board of Nursing or Board of Pharmacy position statement on IV hydration was found. | Provisional |
| Kansas | Prescriber assessment and individualized order required | The Kansas Board of Healing Arts and Board of Pharmacy issued a joint statement on February 25, 2026: IV administration of any drug, including saline, | Provisional |
| Kentucky | Individualized prescriber exam and order; standing orders rejected | Kentucky’s medical, nursing and pharmacy boards issued a joint statement on retail IV therapy (March 28, 2025). | Verified |
| Louisiana | Individualized prescriber exam and order; standing orders rejected | The Louisiana State Board of Medical Examiners’ statement of position (August 2024): “A full in-person or virtual history and examination must be perf | Verified |
| Maine | Individualized prescriber exam and order; standing orders rejected | Maine’s joint rule (Chapter 15) of the Board of Licensure in Medicine, the Board of Osteopathic Licensure and the Board of Nursing, effective July 14, | Provisional |
| Maryland | No IV-specific board guidance found | No Board of Nursing guidance specific to IV hydration was found for Maryland in the sources searched. | Provisional |
| Massachusetts | No IV-specific board guidance found | No Massachusetts ruling specific to IV hydration was found. | Provisional |
| Michigan | No IV-specific board guidance found | No Michigan Board of Nursing or LARA guidance on IV hydration was found. | Provisional |
| Minnesota | No IV-specific board guidance found | No Minnesota Board of Nursing statement on IV hydration was found. | Provisional |
| Mississippi | Individualized prescriber exam and order; standing orders rejected | The Mississippi Board of Nursing’s position statement (updated October 10, 2025): the RN may administer with “a valid order and a completed history an | Verified |
| Missouri | No IV-specific board guidance found | No State Board of Nursing guidance specific to IV hydration was found for Missouri in the sources searched. | Provisional |
| Montana | No IV-specific board guidance found | No Board of Nursing guidance specific to IV hydration was found for Montana in the sources searched. | Provisional |
| Nebraska | Prescriber assessment and individualized order required | The Nebraska Board of Nursing’s advisory opinion (revised February 2026): “An order from a LP to administer medication or IV therapy (including hydrat | Verified |
| Nevada | Prescriber assessment and individualized order required | The Nevada State Board of Nursing practice decision (approved November 18, 2020): the RN “must have an order from a qualified licensed practitioner wh | Verified |
| New Hampshire | No IV-specific board guidance found | No Board of Nursing guidance specific to IV hydration was found for New Hampshire in the sources searched. | Provisional |
| New Jersey | No IV-specific board guidance found | No New Jersey Board of Nursing guidance on IV hydration was found. | Provisional |
| New Mexico | Prescriber assessment and individualized order required | The New Mexico Medical Board’s policy (revised August 21, 2025), developed with the Boards of Nursing and Pharmacy: IV therapy for hydration, nutritio | Verified |
| New York | Individualized prescriber exam and order; standing orders rejected | New York requires an RN to execute medical regimens ordered for a specific patient by a practitioner who examined that patient. | Verified |
| North Carolina | Individualized order; written standing orders contemplated | The North Carolina Board of Nursing’s position statement (origin September 2022) covers walk-in or mobile hydration clinics and drip bars. | Verified |
| North Dakota | Prescriber assessment and individualized order required | The North Dakota Board of Nursing’s practice guidance (December 2024) covers IV hydration clinics, medical spas and mobile IV infusion services. | Verified |
| Ohio | Individualized prescriber exam and order; standing orders rejected | Ohio’s medical, pharmacy and nursing boards’ joint statement (May 15, 2025): diagnosis and recommendation of IV therapy, including discussing “cocktai | Verified |
| Oklahoma | Individualized prescriber exam and order; standing orders rejected | Oklahoma Board of Nursing IV Hydration Guidelines, P-24 (approved March 24, 2026; revised May 19, 2026), cover walk-in and mobile hydration clinics. | Verified |
| Oregon | Prescriber assessment and individualized order required | The Oregon State Board of Nursing’s interpretive statement (October 16, 2024): only physicians, PAs, APRNs with prescriptive privilege and naturopaths | Verified |
| Pennsylvania | No IV-specific board guidance found | No Pennsylvania State Board of Nursing statement on IV hydration was found. | Provisional |
| Rhode Island | Individualized prescriber exam and order; standing orders rejected | RIDOH’s guidance (July 2024), issued with the professional boards: before any service the patient “must first be assessed by a Rhode Island licensed p | Verified |
| South Carolina | Individualized prescriber exam and order; standing orders rejected | South Carolina’s medical, pharmacy and nursing boards’ joint advisory opinion (August 15, 2023): “There is no question that the services being provide | Verified |
| South Dakota | Prescriber assessment and individualized order required | The South Dakota Board of Nursing’s guidelines are reported to require that an LPN or RN have a medical order to administer medication or IV therapy, | Provisional |
| Tennessee | No IV-specific board guidance found | No board of nursing or medical board guidance specific to IV hydration was found for Tennessee in the sources searched. | Provisional |
| Texas | State statute: physician orders or delegates (Tex. Occ. Code ch. 172) | Texas Occupations Code chapter 172 (HB 3749, “Jenifer’s Law”, effective September 1, 2025) governs “elective intravenous therapy”: IV fluids, nutrient | Verified |
| Utah | No IV-specific board guidance found | No board of nursing or medical board guidance specific to IV hydration was found for Utah in the sources searched. | Provisional |
| Vermont | Individualized prescriber exam and order; standing orders rejected | Vermont’s joint statement of the Office of Professional Regulation and the medical, nursing, osteopathic and pharmacy boards (2024; final approval Jun | Verified |
| Virginia | No IV-specific board guidance found | No Board of Nursing guidance specific to IV hydration was found for Virginia in the sources searched. | Provisional |
| Washington | Under board review (including drafts), or guidance located but not read | Washington’s Nursing Commission advisory opinion NCAO 24.00, “Infusion Therapy Management” | Provisional |
| West Virginia | Under board review (including drafts), or guidance located but not read | The West Virginia RN Board has a position statement on the role of the APRN, RN and LPN in IV therapy; its content and date were not read. | Provisional |
| Wisconsin | Prescriber assessment and individualized order required | Wisconsin’s Joint Advisory Opinion of the medical, nursing, pharmacy and cosmetology examining boards, the Physician Assistant Affiliated Credentialin | Verified |
| Wyoming | No IV-specific board guidance found | No Board of Nursing guidance specific to IV hydration was found for Wyoming in the sources searched. | Provisional |