Update on Missouri’s Levels of Supervision: What RVTs, Students, and Clinics Need to Know

Missouri has made recent updates to its Levels of Supervision rules that affect how veterinary teams are recognized and supervised in practice. These updates occurred in stages and include rule text changes that are already in effect and an updated supervision chart that will take effect soon.

This summary focuses on what veterinary teams need to know, with emphasis on Registered Veterinary Technicians (RVTs), RVT students, certified veterinary assistants, and clinics.

What Is Already in Effect

Rule text update — effective April 30, 2025

As of April 30, 2025, Missouri amended 20 CSR 2270-4.060 (Minimum Standards for Supervision).

What teams should know:

  • The rule text was updated to clarify supervision standards and expectations
  • The update formally recognizes additional personnel categories, including:
    • Registered Veterinary Technician (RVT) Students
    • Certified Veterinary Assistants (CVAs)
  • These roles are now explicitly acknowledged in regulation, rather than being implied or grouped under other categories
  • The Levels of Supervision chart itself did not change at that time

What this means for teams:
RVT students and certified veterinary assistants are now clearly identified as distinct roles within Missouri’s supervision framework, providing clearer guidance for clinics, educators, and supervising veterinarians.

What’s Coming Next: Updates to the Levels of Supervision Chart

Missouri has approved updates to the Levels of Supervision chart, which provides task-specific guidance on how supervision applies in practice.

  • The updated chart was amended and published in the Missouri Register on January 2, 2026
  • The chart has been approved through rulemaking
  • The chart is not yet effective
  • It will become effective 30 days after publication in the Code of State Regulations (CSR)

Until the official effective date, clinics must continue following the current CSR Levels of Supervision chart.

What the Updated Chart Will Change Once Effective

The updated chart builds on the earlier rule text changes by providing clear, task-specific supervision guidance.

MO levels of supervision 2026 changes

Registered Veterinary Technician (RVT) Students

  • RVT students appear as a formal, distinct category
  • Supervision expectations are clearly outlined for students enrolled in accredited veterinary technology programs
  • This aligns regulatory language with how externships and clinical instruction function in practice

What this means for clinics:
Clearer expectations when hosting students, with supervision guidance that supports education while maintaining appropriate oversight.

Certified Veterinary Assistants (CVAs)

  • Certified veterinary assistants are explicitly distinguished from unregistered assistants
  • Certification is acknowledged while maintaining existing task limitations

What this means for clinics:
Improved clarity when assigning tasks and determining supervision for certified assistants.

Registered Veterinary Technicians (RVTs)

Once the updated chart becomes effective:

  • Some RVT tasks shift from Direct supervision (B) to Indirect supervision (C)
  • Under the updated chart, certain RVT-performed tasks may be completed under Indirect supervision, provided a veterinarian has examined the patient, established a treatment plan or protocol, and remains available for consultation. These shifts apply to:
    • Administration of treatments ordered by a veterinarian
    • Administration of non-rabies biologics under established veterinary direction
    • Select patient care and treatment-related tasks that do not involve diagnosis, surgery, prescribing, or establishment of treatment plans

These changes affect how supervision occurs, not who makes medical decisions. Veterinarians still retain full responsibility for diagnosis, treatment planning, and overall medical decision-making.

What Veterinary Teams Should Do Now

✔ Continue following the current CSR Levels of Supervision chart

✔ Be aware that RVT students and certified veterinary assistants are now formally recognized roles

✔ Review the updated chart so you are familiar with upcoming supervision changes

❌ Do not implement chart-based changes until the official effective date is announced

Timeline at a Glance

  • April 30, 2025
    • Rule text updated; RVT students and certified veterinary assistants formally recognized
  • January 2, 2026
    • Levels of Supervision chart amended (published in Missouri Register)
  • Early 2026 (anticipated)
    • Chart published in CSR
    • Becomes effective 30 days after CSR publication

Bottom Line for Veterinary Teams

  • Missouri’s supervision rules now explicitly recognize RVT students and certified veterinary assistants
  • A revised Levels of Supervision chart is coming that will define how supervision applies in practice
  • RVTs will see limited, targeted shifts to indirect supervision for certain tasks once effective
  • No workflow changes should be made until the chart is officially effective

These updates are intended to improve clarity, consistency, and alignment with real-world veterinary practice while preserving veterinarian oversight and patient safety.

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