Nurse Practitioner Collaborative Agreement: What It Is and Which States Require One

A nurse practitioner collaborative agreement is a written agreement with a physician that state law requires before an NP may practice or prescribe. AANP files 23 of the 50 states and DC as reduced or restricted practice, where an agreement or supervision is the default, and several of the 28 full practice jurisdictions require one for your first few thousand hours. What the agreement must contain, and how long it lasts, is set state by state.

If you're choosing an FNP program, this matters more than it seems. The same degree leads to a solo practice in one state and a signed agreement with chart reviews every two weeks in the next. Here's what the document is and what the statutes in 43 states actually require.

What is a nurse practitioner collaborative agreement?

It's a document you and a physician sign, and in most states it's filed with or approved by a board. It isn't an employment contract, though your employer may arrange it. It exists because state law says some part of NP practice, usually prescribing, needs a named physician behind it.

The names vary, which is why searching for the rule in your state can be confusing:

• Prescriptive authority agreement in Texas, where prescribing is delegated by a physician who registers the delegation with the Texas Medical Board.
• Standardized procedures in California, written jointly with a supervising physician.
• Standard care arrangement in Ohio.
• Nurse protocol agreement in Georgia.
• Joint protocols in New Jersey.
• Written authorization in Michigan, which covers only controlled substances.
• Supervision agreement in Oklahoma, filed with the physician's own board.
• Transition-to-practice agreement in Nebraska, which covers your first 2,000 hours.

AANP's three categories describe how heavy the requirement is. Its State Practice Environment map defines reduced practice as requiring "a career-long regulated collaborative agreement" and restricted practice as requiring "career-long supervision, delegation or team management." As the next sections show, career-long isn't always accurate.

What state law says the agreement must contain

Statutes differ in detail but ask for the same handful of things. Across the states we've read, an agreement typically has to cover:

• Who signs. Both names and license numbers, and in many states a physician in the same or a similar specialty. Ohio and Georgia both require a comparable specialty.
• What you may prescribe. Texas wants the categories of drugs you may and may not prescribe. Michigan requires both names and both DEA numbers on a controlled substance prescription.
• Consultation and referral. How you reach the physician and when a patient goes to them. Pennsylvania requires a physician reachable immediately by direct communication.
• Emergencies and coverage. Who covers when either of you is away.
• Chart review. How many of your records the physician reads, and how often.
• Filing and updates. Ohio wants your collaborating physician's details filed within 30 days, and New Jersey requires both parties to review and sign the protocols at least annually.

How often does the physician review your charts?

This is the part that shapes your working week. Some states leave review to the agreement. Others write the numbers into statute or board rules:

• Missouri: at least 10% of your charts every 14 days, plus at least 20% of the charts where you prescribed a controlled substance. The physician also has to be on site at least once every two weeks when you're treating acute or chronic conditions.
• Tennessee: the physician personally reviews at least 20% of your charts every 30 days and visits any remote site every 30 days.
• Georgia: every record for a patient prescribed a controlled substance is reviewed quarterly, adverse outcomes within 30 days, and 10% of all other records once a year.
• Alabama: under two years or 4,000 hours of collaborative experience, the physician must be present for at least 10% of your scheduled hours.
• Indiana: at least a 5% random sample of your charts and prescriptions.
• New York: records reviewed at least once every three months, until you pass 3,600 hours.

If you're comparing job offers in one of these states, ask who your collaborating physician will be and how the review happens in practice. A physician who works down the hall is a different arrangement from one you've never met.

When does the collaborative agreement end?

AANP's category tells you the ceiling, not how long it takes to reach it. In 17 of the 43 states we've read, the statute sets a point where the agreement stops. 9 of those are full practice states that phase it in, and 8 are reduced or restricted states that let you out.

Read from each state's statute or board rules, as cited in Sources below. AANP categories from its State Practice Environment map, retrieved July 29, 2026.

A few of these are worth reading closely. Florida is restricted, but its autonomous practice route after 3,000 clinical practice hours is limited to primary care, defined as family medicine, general pediatrics and general internal medicine. That's the ground an FNP is trained for. It also asks for graduate coursework in differential diagnosis and pharmacology within the prior five years.

In Kentucky, the clock runs separately for non-scheduled drugs and controlled substances, four years each. And in Vermont, adding a second population focus starts a new clock of 12 months and 1,600 hours for that focus, so an FNP who later adds psychiatric certification goes back under an agreement for that work.

Where the agreement doesn't end, the statutes say so plainly. Pennsylvania, New Jersey and North Carolina have no hours or years threshold that releases you.

Does the collaborator have to be a physician?

Usually, but not always. Maine's 24 months of supervised practice can be served under a supervising nurse practitioner with at least five years as an APRN in the same specialty. Vermont lets an APRN with four years of experience serve as the collaborating provider, and Minnesota's agreement can be with physicians or experienced APRNs.

Maryland dropped the physician agreement in 2015. What remains is an 18-month mentor, either a certified NP or a physician, named on your initial application.

The supply of physicians is limited in some states, too. Ohio caps a physician at collaborating on prescribing with five nurses at once, and Missouri allows no more than six full-time-equivalent APRNs, PAs or assistant physicians combined. Oklahoma's statute lists fees charged to the APRN among the agreement's terms, so supervision can be something you pay for.

What this means when you're choosing an FNP program

Your program doesn't change your state's rule, but it does decide where you're ready to practice. A few practical points:

• Plan for the state you'll work in, not the one the school is in. The rule that governs you is the one where you're licensed, wherever you studied. Read your target state's rule before you enroll, on our FNP scope of practice guide or your state's page under FNP programs by state.
• The runway is paid work, not school. Hours toward a transition to practice are counted after you're licensed or certified as an NP. Student clinical hours don't count.
• A residency can be your runway. A postgraduate FNP residency puts you in a supervised first year by design, which suits a state that requires one anyway.
• Prescribing is usually where the rule bites. Our guide to whether nurse practitioners can prescribe medication covers controlled substances state by state.

Once you know where you want to practice, compare programs in our FNP program rankings or the online FNP programs list.