---
title: "What Are Standing Orders? Med Spa and Nursing Rules"
description: "Standing orders let nurses act under a prescriber's written protocol. How they work, their limits for prescription drugs, and how Cuvo Health handles care."
canonical: "https://cuvo.co/glossary/standing-orders"
last-updated: "Oct 26, 2026"
---
**Definition:** A standing order is a written protocol, approved by a physician or other authorized prescriber, that lets nurses or other trained staff carry out a defined intervention for patients who meet set criteria, without a new patient-specific order each time.

# What are standing orders?

A standing order is how a prescriber's instructions reach the nurses and staff who carry them out, without a new order for every patient. It is a delegation tool, and each state's medical and nursing rules decide how far it reaches. Cuvo Health runs telehealth on individual review instead: a licensed provider evaluates each patient and makes every clinical decision.

Published Oct 26, 2026. Facts reviewed Oct 26, 2026.

A standing order is a written protocol, approved by a physician or other authorized prescriber, that lets nurses or other trained staff carry out a defined intervention for any patient who meets set criteria, without a new patient-specific order each time. Vaccination is the textbook case: the Community Preventive Services Task Force describes standing orders that let nurses and pharmacists, where state law allows, assess immunization status and vaccinate under an approved protocol. In a med spa, a standing order is how a supervising prescriber's instructions reach the nurses who carry them out, within limits each state's medical and nursing rules set. On Cuvo Health, telehealth care runs on individual review instead: a licensed provider evaluates each patient and makes every clinical decision.

**At a glance**
- What it is: A prescriber-approved protocol staff follow for patients who meet set criteria
- Classic use: Vaccination, recommended by the Community Preventive Services Task Force since March 2015
- Federal hospital rule: 42 CFR 482.24(c)(3): approved, evidence-based, reviewed and authenticated
- Limit: State delegation, scope-of-practice and examination rules still apply
- On Cuvo: Each telehealth patient reviewed by a provider licensed where the patient is

**The safeguards Medicare's hospital rule attaches to standing orders (42 CFR 482.24(c)(3))**

| Condition | What it requires |
| --- | --- |
| **Approval** | Reviewed and approved by the medical staff and the hospital's nursing and pharmacy leadership |
| **Evidence** | Consistent with nationally recognized and evidence-based guidelines |
| **Review** | Periodic and regular review of the orders' continuing usefulness and safety |
| **Authentication** | Dated, timed and authenticated promptly in the record by the ordering or another responsible practitioner acting under state law |

## 01. Why do standing orders matter for a med spa?

They let one prescriber's protocol govern work that nurses and other staff perform across many clients and many days. Which tasks may be delegated, to whom and under what supervision is set by each state's medical and nursing boards, so a protocol that works in one state may not transfer to the next. A standing order also does not remove a state's examination rules for prescription drugs: in California, prescribing, dispensing or furnishing a dangerous drug without an appropriate prior examination and a medical indication is unprofessional conduct (Business and Professions Code section 2242(a)). That is why a protocol is paired with a good faith exam.

## 02. How is a standing order different from a prescription?

A prescription is written for one patient by one practitioner; a standing order is written in advance for a group of patients. The difference is sharpest for controlled substances. A controlled substance prescription is effective only if an individual practitioner issues it for a legitimate medical purpose in the usual course of professional practice (21 CFR 1306.04(a)), and an electronic one must be signed with that practitioner's own two-factor credential, which may not be shared or used by anyone else (21 CFR 1311.102(a)).

## 03. How are standing orders kept safe in hospitals?

Medicare's hospital conditions of participation spell out federal safeguards. A hospital may use pre-printed and electronic standing orders, order sets and protocols only if they are approved by the medical staff with nursing and pharmacy leadership, consistent with evidence-based guidelines, reviewed regularly, and authenticated promptly in the patient's record (42 CFR 482.24(c)(3)). The rule binds hospitals, not med spas, but it is a clear statement of what a well-governed protocol includes.

## 04. How does Cuvo handle orders for telehealth patients?

Telehealth prescribing on Cuvo runs on individual review. Each intake is reviewed by a provider licensed where the patient is located, who makes every clinical decision, and clinical protocols and care quality are governed by the licensed providers in the network. Approved prescriptions go out over Surescripts to licensed partner pharmacies, with EPCS on Grow and above. For a med spa adding GLP-1 or hormone programs by telehealth, Cuvo's providers review those patients and make the prescribing decisions while the spa's own protocols stay with its in-clinic services, at $25 per completed consult and no revenue share.

## Frequently asked questions

**Q: What are standing orders?**

A: Standing orders are written protocols, approved by a physician or other authorized prescriber, that let nurses or other trained staff carry out a defined intervention for patients who meet set criteria without a new order each time. On Cuvo, telehealth prescribing runs on individual review: a provider licensed in the patient's state reviews each intake.

**Q: What are standing orders in nursing?**

A: In nursing, a standing order lets a nurse act under a prescriber's approved protocol, such as assessing immunization status and vaccinating eligible patients, where state law allows. On Cuvo, every telehealth patient is reviewed by a provider licensed in the patient's state.

**Q: Can a med spa use standing orders for injectables?**

A: A med spa can use standing orders to direct how staff carry out treatment within its state's delegation rules, but the protocol does not replace the examination a prescription drug requires, such as California's appropriate prior examination. On Cuvo, good faith exams are included on every plan, run by licensed providers.

**Q: Standing order vs prescription: what is the difference?**

A: A prescription is issued by one practitioner for one patient; a standing order is a protocol written in advance for a group of patients. On Cuvo, every prescription follows a licensed provider's review of the individual patient.

**Q: Does a telehealth brand need standing orders?**

A: Usually not for prescribing: a telehealth prescription follows a licensed provider's review of each patient, and controlled substance prescriptions must come from an individual practitioner. Cuvo Health supplies those providers, licensed in all 50 states, so every prescribing decision stays with a licensed provider.

**Related pages**

- [Good faith exam](/glossary/good-faith-exam): The patient-specific exam a protocol cannot replace
- [Telehealth for med spas](/solutions/med-spas): Prescription programs run behind a med spa's brand
- [Med spa ownership rules by state](/blog/med-spa-ownership-rules-by-state): Ownership and supervision rules state by state
- [Cuvo provider network](/provider-network): Who reviews each patient, and where they are licensed
- [Telehealth glossary](/glossary): Every term a telehealth founder meets

Canonical page: https://cuvo.co/glossary/standing-orders