Missouri

Missouri Collaborating Physician Jobs – Top Opportunities for Licensed Physicians

Missouri’s “Show-Me State” approach to NP collaboration is one of the most specific in the country — in-person presence requirements, a combined 6-FTE cap, same field of medicine, and biennial BOHA reporting. The 75-mile proximity rule was eliminated in 2023, making telehealth-based collaboration fully viable. With a large NP and PA workforce across Kansas City, St. Louis, Springfield, and the Missouri Ozarks, demand for collaborating physicians is consistent and well-structured.

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⏱ Get started in 24–48 hours 🌐 75-mile rule ELIMINATED (Aug 2023) — telehealth CPA available ✅ 6 FTE combined cap — focused, premium physician demand 💰 Permanent — no NP or PA independence pathway in Missouri

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75-mile proximity rule eliminated (August 28, 2023): Missouri amended RSMo § 334.104 to remove the geographic proximity requirement from joint rulemaking authority. Both the Missouri Board of Nursing and the Board of Registration for the Healing Arts subsequently rescinded the 75-mile definition. Geographic proximity is no longer enforced in Missouri — and the Collaborative Practice Arrangement may explicitly waive geographic proximity when it outlines the use of telehealth. Remote collaboration with Missouri NPs is now fully supported in statute.

6 FTE

Combined maximum — physician cannot have more than 6 FTE APRNs, PAs, and assistant physicians combined (RSMo § 334.104)

Same field

Physician and NP must practice in the same field of medicine — required for all Missouri collaborative practice arrangements

Permanent

No independence pathway for NPs or PAs — physician collaboration required throughout an NP’s and PA’s career in Missouri

Missouri’s On-Site Presence Requirements

When On-Site Presence Is Required — and When Remote Works

Missouri’s on-site requirements are location-specific and practice-type-specific. Understanding these rules is essential for structuring a compliant arrangement before patient care begins.

Missouri on-site presence rules under RSMo § 334.104 and 20 CSR 2200-4.200:

New Location — First Month

1/3 of NP’s Time at Same Location (First Month)

When a new collaborative practice begins at a location where the physician is NOT continuously present, the physician must be present at the SAME LOCATION for at least one-third of the NP’s time practicing there during the first month. This applies to all new arrangements at non-physician-present locations. Exception: does not apply when collaborating physician is new to NP’s established patient population in primary/behavioral health care.

Acute/Chronic Illness Settings — Ongoing

Biweekly On-Site Visits with Chart Review

For collaborative arrangements covering acutely or chronically ill or injured patients, the physician (or designated physician) must be present at the same location at least once every two weeks — except in documented extraordinary circumstances. Each biweekly visit must include chart review, medical direction, and clinical services. This is the most demanding ongoing site-visit requirement in the series.

Telehealth Waiver — Available

Geographic Proximity Waived for Telehealth CPAs

The Collaborative Practice Arrangement may explicitly waive geographic proximity when it outlines the use of telehealth (defined under § 191.1145). This waiver, combined with the 2023 elimination of the 75-mile rule, makes fully remote Missouri CPA arrangements legally viable for appropriate practice settings.

Exemptions

Hospital, Rural Health, and FQHC Exemptions

The 6-FTE cap and some location requirements do not apply to hospital employees providing inpatient care or population-based public health services. Rural health clinics may waive geographic proximity for up to 28 days per year. Critical access hospitals and FQHCs have additional flexibility under federal exemptions.

Why Missouri

Missouri’s Combined 6-FTE Cap, Same-Field Requirement, and 2023 Proximity Reform Create a Structured, Premium Physician Collaboration Market

Missouri is a restricted practice state with no NP or PA independence pathway. Every APRN must have a written Collaborative Practice Arrangement (CPA) under RSMo § 334.104, and every PA must have a collaborative agreement under RSMo § 334.735. The physician must practice in the same field of medicine as the NP, and the combined 6 FTE cap — covering APRNs, PAs, and assistant physicians together — limits per-physician supply and drives demand.

Missouri’s 2023 reform eliminated the 75-mile proximity rule that had long constrained the market — replacing it with a framework where geographic proximity can be waived when the CPA outlines telehealth use. The physician must still advise the Missouri State Board of Registration for the Healing Arts (BOHA) within 30 days of any change in collaborative arrangements and with each license renewal.

Missouri’s combination of a permanent collaboration requirement, same-field restriction, 6-FTE combined cap, and specific on-site requirements for acute/chronic illness settings produces per-physician compensation among the highest in the Midwest. Qualified, engaged physicians in Missouri are consistently in demand from NPs and PAs across Kansas City, St. Louis, and the state’s large rural Ozarks corridor.

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Missouri State Requirements

Written Collaborative Practice Arrangement (CPA) required for all APRNs. No more than 6 FTE APRNs/PAs/assistant physicians combined per physician. Physician and NP must practice in the same field of medicine. Physician must be immediately available for consultation at all times, personally or via telecom. RSMo § 334.104; 20 CSR 2200-4.200

New location where physician is NOT continuously present: physician must be physically present at same location for at least 1/3 of NP’s time in the first month. Exception for primary/behavioral health physicians new to NP’s established patient population. Exception for telehealth-outlined CPAs. RSMo § 334.104(3); 20 CSR 2200-4.200

Acute/chronic illness settings: physician (or designated physician) must be present at same location at least once every two weeks, except in documented extraordinary circumstances, to participate in chart review and provide medical direction, services, and consultation. RSMo § 334.104(3)(11)

Collaborating physician must advise BOHA within 30 days of any change in collaborative arrangements AND with each physician license renewal. 75-mile proximity rule eliminated August 28, 2023 — geographic proximity now waivable with telehealth CPA. No independence pathway for NPs or PAs. RSMo § 334.104; Zivian Health MO 2025

PA collaborative agreements under RSMo § 334.735 — also subject to 6 FTE combined cap. Physician must be continuously present for an initial period before PA practices independently. Same field of medicine required. Monthly contact required. PAs also under 6 FTE combined cap. RSMo § 334.735

Your Role

What a Collaborating Physician Does in Missouri

Missouri’s CPA framework is specific about on-site requirements, field-of-medicine alignment, BOHA reporting, and the 6-FTE cap. We structure and coordinate every element from day one.

Sign the Collaborative Practice Arrangement

Execute the written CPA with the NP — defining scope of practice, prescriptive authority (including specific controlled substances authorized), geographic proximity provisions (including telehealth waiver where applicable), and on-site schedule. Agreement filed with and reportable to BOHA.

First-Month On-Site Presence (New Locations)

For new arrangements at locations where you are not continuously present, be physically present at the NP’s practice location for at least one-third of the NP’s working time during the first month. This initial presence period establishes the collaborative relationship and is documented in the CPA.

Biweekly Site Visits for Acute/Chronic Care

For NPs treating acutely or chronically ill patients, conduct in-person site visits at least once every two weeks — with chart review, medical direction, and clinical consultation provided at each visit. We schedule and document all biweekly visits and maintain records available for BOHA inspection.

Be Immediately Available for Consultation

Be immediately available for consultation at all times, either personally or via telecommunications. Missouri requires this as a continuous obligation — not just during scheduled hours. For telehealth-based CPAs, this standard is satisfied by telecommunication availability.

BOHA Reporting — 30 Days and License Renewal

Advise the Missouri State Board of Registration for the Healing Arts within 30 days of any change in collaborative arrangements. Also report the existence of collaborative arrangements with each physician license renewal. We coordinate all BOHA notifications and renewal disclosures on time.

Earn Premium Income — Up to 6 FTE Combined

Receive income for each NP CPA and PA collaborative arrangement — up to 6 FTE combined. Missouri’s same-field requirement and 6-FTE cap drive per-physician compensation among the highest in the Midwest, particularly for physicians in high-demand specialties like primary care, psychiatry, and aesthetics.

Simple Process

Get Started in 3 Simple Steps

Many physicians in our network are matched and onboarded within 24 to 48 hours.

Apply

Submit your credentials, Missouri medical license, and same-field specialty. It takes less than 2 minutes. We verify field-of-medicine alignment and your current combined FTE count before matching.

Get Matched

We connect you with Missouri NPs and PAs in your same field of medicine — across Kansas City, St. Louis, Springfield, Columbia, and statewide — within your 6 FTE combined cap, with the right on-site structure for the practice type.

Start Collaborating

Begin with a fully compliant Missouri CPA — with telehealth proximity waivers where applicable, first-month on-site scheduling coordinated, biweekly visit tracking for acute/chronic settings, and BOHA 30-day notifications managed.

Apply Now — Takes Less Than 2 Minutes

Our Difference

A Smarter Way to Work as a Missouri Collaborating Physician

Missouri’s same-field requirement, 6-FTE combined cap, first-month on-site presence, biweekly acute/chronic visits, telehealth waiver structuring, BOHA 30-day and renewal reporting, and PA initial presence period all need precise coordination. We handle all of it.

Same-field matching verified upfront

Missouri’s CPA requires the physician and NP to practice in the same field of medicine. We verify this alignment before every introduction — ensuring compliance from the start.

Start within 24–48 hours

Many Missouri physicians in our network are matched and onboarded within 24 to 48 hours.

RSMo § 334.104-compliant CPAs

Our Collaborative Practice Arrangements meet Missouri BOHA and Board of Nursing requirements — including telehealth proximity waivers, controlled substance formulary specifics, and on-site schedule documentation.

On-site scheduling and biweekly visit documentation

We coordinate the first-month 1/3-time presence schedule, schedule all biweekly acute/chronic setting visits, and maintain documentation records available for BOHA audit.

BOHA notifications — 30 days and renewals

We coordinate all Missouri BOHA change notifications within the required 30-day window and prepare license renewal disclosures — keeping you fully compliant with Missouri’s reporting requirements.

Permanent income — no independence pathway

Missouri has no NP or PA independence pathway. Your collaboration income is permanent and stable — supported by one of the largest NP and PA workforces in the Midwest, across two major metropolitan areas and a substantial rural market.

Missouri Clinics

Missouri Clinic Types We Work With

Every Missouri NP needs a same-field physician CPA — permanently. From Kansas City’s booming medspa corridor and St. Louis’ suburban healthcare market to Springfield and the Ozarks’ rural healthcare network.

💆Medical Spas

⚖️Weight Loss Centers

💉IV Hydration

💻Telehealth Platforms

🏥Primary Care

🧠Psychiatry Practices

⭐Specialty Clinics

🩺Wellness Centers

Is This For You?

This Opportunity Is Ideal For

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Physicians with an active Missouri medical license in good standing with BOHA

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Physicians who practice in the same field of medicine as the NP’s certification and specialty area

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Those seeking premium Midwest income from Missouri’s permanent collaboration requirement and 6-FTE combined cap structure

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Physicians comfortable with Missouri’s on-site presence requirements, BOHA reporting, and biweekly visits for acute/chronic care settings

Your Missouri medical license must be active and in good standing with BOHA. You must practice in the same field of medicine as the NP. No proximity requirement applies (75-mile rule eliminated), and telehealth-based CPAs are explicitly supported. On-site presence requirements apply for the first month at new locations and ongoing for acute/chronic illness settings.

Collaborating Physician Jobs in Missouri

Missouri Collaborating Physician Jobs — Permanent Demand Across Kansas City, St. Louis, and the Show-Me State

Missouri has no NP or PA independence pathway, which means every prescribing NP and every supervised PA in the state needs a physician collaborator for as long as they practice in Missouri. That structure produces one of the most stable and consistently active markets for collaborating physician jobs in the Midwest — from Kansas City’s growing medspa and wellness corridor to St. Louis’s urban healthcare market, Springfield’s Ozarks health systems, and Missouri’s extensive rural communities. For providers looking to find collaborating physician partners in Missouri, and for physicians seeking consistent supplemental income, demand here is built into the permanent regulatory architecture of the state.

Long-Term Collaborating Physician Jobs — No Independence Pathway

Because Missouri requires physician collaboration permanently for both NPs and PAs, every arrangement entered into today is a long-term income source rather than a temporary window. An NP who opens a medspa on the Country Club Plaza or a weight loss clinic in Chesterfield needs a same-field collaborating physician from day one and every year thereafter. This permanence makes Missouri collaborating physician jobs more stable than those in states with transition-to-independence pathways — there is no expiration date built into the arrangement.

Collaborating Physician for Nurse Practitioners — Remote-Eligible Since 2023

Since Missouri eliminated its 75-mile proximity rule in August 2023, the fastest-growing segment of collaborative arrangements in the state is in fully or largely remote work for NPs operating medspas, telehealth platforms, GLP-1 weight loss clinics, and IV hydration practices. A physician serving as a collaborating physician for nurse practitioners in Missouri can now structure the entire arrangement around telehealth availability — with no required on-site visits for most practice types and the geographic proximity provision explicitly waived in the CPA.

Scale Up to 6 FTE — Missouri’s Combined Cap Structure

Missouri’s 6 FTE combined cap covers APRNs, PAs, and assistant physicians together — giving physicians meaningful flexibility to build a portfolio of collaborative arrangements across different practice types and clinical settings. Physicians seeking to scale their supplemental income can hold up to 6 FTE arrangements simultaneously, with each one contributing to a diversified, multi-stream income that does not depend on any single clinic or provider type.

Supplemental Income Structured Around Your Schedule

Missouri physician collaboration arrangements are structured as part-time, supplemental roles — not second clinical positions. Your obligations under the CPA are defined: same-field availability, BOHA reporting, on-site scheduling for the first month and for acute/chronic illness settings, and documented consultation. Everything else — patient scheduling, staffing, billing, and day-to-day operations — belongs to the NP or PA. Most physicians hold Missouri collaboration arrangements alongside their primary practice with a predictable, manageable time commitment per clinic per month.

CollaboratingPhysician.com maintains an active roster of physician collaboration opportunities across Missouri and matches physicians with NP and PA practices within 24 to 48 hours of applying. We are not a job board — we actively help you find collaborating physician openings on your behalf, verify same-field alignment, structure CPAs to meet RSMo § 334.104 requirements, coordinate first-month on-site scheduling, and manage all BOHA 30-day notifications and renewal disclosures throughout the arrangement. Whether you are looking for collaborating physician jobs in Kansas City, St. Louis, Springfield, or anywhere across Missouri, we make the process straightforward from day one.

FAQ

Frequently Asked Questions — Missouri

Is physician collaboration permanently required for Missouri NPs?

Yes. Missouri is a restricted practice state with no hours-based or experience-based independence pathway for NPs. Every APRN must have a written Collaborative Practice Arrangement with a physician for the duration of their practice in Missouri. Similarly, Missouri PAs require physician collaboration throughout their careers under RSMo § 334.735. There is no legislative pathway to independence for either NPs or PAs under current Missouri law.

Is the 75-mile proximity rule still in effect in Missouri?

No. Missouri amended RSMo § 334.104 effective August 28, 2023 to remove geographic proximity from the joint rulemaking authority of the Board of Nursing and the Board of Registration for the Healing Arts. Both boards subsequently voted to rescind the joint rule that had defined geographic proximity as 75 miles. The Missouri Board of Nursing confirmed it would not enforce the 75-mile definition as of September 2023. Geographic proximity is now determined by the parties and can be explicitly waived in CPAs that outline the use of telehealth. Remote Missouri CPA arrangements are fully legally supported under current law.

What is the first-month on-site presence requirement?

Under RSMo § 334.104(3), when an NP enters into a CPA at a location where the collaborating physician will not be continuously present, the physician must be physically present at the same location for at least one-third of the NP’s time practicing there during the first month. For example, if the NP practices 40 hours per week at a new location, the physician must be present on-site for at least 13-14 of those hours in the first month. This requirement does not apply when the collaborating physician is new to a patient population already established under the NP’s care (primary care or behavioral health exception), and it does not apply to telehealth-based CPAs that explicitly waive proximity.

What are the biweekly on-site visit requirements?

Under RSMo § 334.104(3)(11), when an NP’s collaborative arrangement covers clinical situations involving acutely or chronically ill or injured patients, the physician (or a designated physician in the CPA) must be present at the same location at least once every two weeks, except in extraordinary circumstances which must be documented. Each biweekly presence must include: participating in chart review, providing necessary medical direction, rendering clinical services as appropriate, and providing consultation to the health care staff. This is among the most specific ongoing on-site visit requirements in this series — applying specifically to the acutely/chronically ill patient context.

What is Missouri’s 6 FTE combined cap?

Under RSMo § 334.104, a collaborating physician may not enter into collaborative practice arrangements with more than 6 full-time equivalent APRNs, PAs, and/or assistant physicians combined. This is a combined cap — not separate limits for NPs and PAs. If a physician collaborates with 4 FTE NPs and 1 FTE PA, that counts as 5 FTE and leaves room for 1 more. Hospital employees providing inpatient care and population-based public health services are exempt from this cap. We track your combined FTE count and ensure you never exceed the 6 FTE limit.

What must be reported to BOHA about Missouri collaborative arrangements?

Under RSMo § 334.104, the collaborating physician must advise the Missouri State Board of Registration for the Healing Arts (BOHA) within 30 days of any change in collaborative practice arrangements — including entering into new arrangements, terminating existing ones, or modifying existing CPAs. Additionally, with each physician license renewal, the physician must disclose to BOHA whether they are engaged in any collaborative practice arrangements. We coordinate both types of notifications — the 30-day change notifications and the renewal disclosures — on your behalf.

How do I find a collaborating physician in Missouri — and what should NPs and PAs look for?

For NPs and PAs: the most reliable way to find a collaborating physician in Missouri is through a managed matching network rather than searching independently. Missouri’s CPA requirements — same-field-of-medicine alignment, first-month on-site presence scheduling, BOHA 30-day notification, the 6 FTE combined cap, telehealth proximity waiver structuring, and biweekly site-visit documentation for acute/chronic settings — make the process more complex than most providers anticipate when they first look to find a collaborating physician. Managed matching ensures the physician is field-aligned, that the CPA is structured correctly for the practice type, and that all BOHA reporting obligations are met from day one. Independent searches through social media or professional directories often produce agreements that miss Missouri-specific documentation requirements and later create compliance problems. For physicians: if you are evaluating collaborating physician jobs in Missouri and want to understand the practical time commitment, a collaborative physician in Missouri has defined, schedulable obligations that fit around a primary practice. The permanent CPA requirement and no-independence-pathway structure mean every arrangement is long-term — making Missouri one of the more stable and reliable markets for supplemental physician income in the Midwest.

What is physician collaboration in Missouri, and what does a collaborative physician actually do?

Physician collaboration in Missouri is the formal arrangement required under RSMo § 334.104 between a Collaborative Practice Arrangement (CPA) physician and a Missouri APRN or PA. A collaborative physician in this context is a licensed MD or DO who practices in the same field of medicine as the NP, signs the written CPA, is immediately available for consultation by phone or telecom, and fulfills the on-site and documentation obligations described in the agreement. The physician does not manage the NP’s patients, staff, or clinical decisions — those remain with the NP. The specific obligations of physician collaboration in Missouri are the same-field availability standard, the first-month on-site presence requirement for new locations, the biweekly site visit for acute/chronic illness settings, and the BOHA 30-day change notification. Beyond those defined obligations, the day-to-day footprint of a Missouri collaborative physician role is manageable alongside a primary clinical practice. This structure is why collaborating physician jobs in Missouri attract physicians looking for consistent, predictable supplemental income that does not require giving up clinical time elsewhere.

Start Building Premium Income as a Missouri Collaborating Physician

Missouri NPs and PAs need same-field physician partners — permanently, with a 6-FTE cap driving per-physician demand across Kansas City, St. Louis, and the Show-Me State. We match you by specialty, structure compliant CPAs, coordinate on-site scheduling, and manage BOHA notifications throughout.