All 50 States

Find Your State’s
Collaborating Physician Guide

Every U.S. state has different laws governing how NPs and PAs collaborate with physicians. Select your state below for a complete breakdown of requirements, income opportunities, and how to get started.

50State Guides

24–48hrTypical Onboarding

$0To Apply

Key:

Restricted practice — permanent NP collaboration

Reduced practice — NP pathway to independence

NP full practice authority — PA collaboration required

NP & PA pathway / PA collaboration

Full independence — both NPs & PAs

50 states shown

Alabama

Restricted NP

Permanent NP collaboration. Collaborative Practice Agreement required. No independence pathway.

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Alaska

NP FPA · PA Collab

NPs fully independent. PAs require collaborative agreement with physician.

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Arizona

NP FPA · PA Collab

NPs fully independent. PAs require a supervisory agreement with physician.

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Arkansas

Reduced NP · PA Collab

NP CPA filed with ASBN. 6,240-hr independence pathway. PA monthly contact required.

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California

NP FPA · PA Collab

NPs fully independent (2023). PAs require a collaboration agreement.

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Colorado

NP Mentorship · PA Collab

NP 750-hr prescriptive mentorship. PA Supervisory Agreement under 5,000 hrs (SB 23-083).

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Connecticut

NP FPA · PA Collab

NPs fully independent. PAs require physician collaboration agreement.

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Delaware

NP FPA · PA 4-Cap

NPs fully independent. PAs require collaboration — 4-PA cap per physician.

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Florida

Restricted NP

Permanent NP collaboration. Protocol filed with Dept. of Health. No independence pathway.

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Georgia

Restricted NP · 4-APRN Cap

Nurse Protocol Agreement filed via ThoughtSpan. 4-APRN cap. 50-mile rule. Board approval required.

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Hawaii

NP FPA · PA Collab

NPs fully independent. PAs require physician collaboration with written agreement.

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Idaho

NP FPA · PA Collab

NPs fully independent. PAs require written collaborative agreement with physician.

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Illinois

Reduced NP

Collaborative agreement required. Transition to independence after 4,000 hrs. Chart review and proximity rules apply.

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Indiana

Restricted NP

Permanent collaboration. 5% weekly chart review. Dual Board filing. Geographic proximity required.

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Iowa

NP FPA · PA Independent

NPs and PAs both fully independent. No physician collaboration required for either.

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Kansas

Restricted NP

Permanent NP collaboration required. Collaborative practice agreement with physician.

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Kentucky

Restricted NP

Permanent NP collaboration. Collaborative practice agreement required with physician.

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Louisiana

Restricted NP

Permanent NP collaboration. Collaborative Practice Agreement. Jointly filed with Board.

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Maine

NP FPA · PA OTP

NPs FPA. PAs under 4,000 hrs need collaborative agreement. LD 2088 (2026) OTP state.

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Maryland

Reduced NP · PA Collab

NP 18-month mentorship then FPA. PA Collaboration Agreement (2024 reform). PCTP designation.

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Massachusetts

Reduced NP · PA Collab

NP 2-year supervised practice then FPA. PAs permanent supervision. Monthly contact required.

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Michigan

Restricted NP

Permanent NP collaboration. Written collaboration agreement filed with LARA. No independence pathway.

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Minnesota

NP FPA · PA 2,080-hr

NPs FPA. PAs need practice agreement for first 2,080 hrs in hospital/integrated settings.

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Mississippi

Restricted NP · 75-mi Rule

MELS gateway filing. 75-mile rule. Quarterly QA meetings. Primary & secondary physician structure.

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Missouri

Restricted NP · 6-FTE Cap

CPA required. 6 FTE combined cap. 75-mile rule eliminated 2023. Same field of medicine.

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Montana

NP FPA · PA 8,000-hr

NPs FPA. PAs under 8,000 hrs need collaborative agreement (HB 313, 2023). Online training required.

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Nebraska

Reduced NP · PA 4-Cap

NP 2,000-hr Transition-to-Practice Agreement. PA permanent supervision — 4-PA cap.

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Nevada

NP FPA · PA Collab

NPs fully independent. PAs require written collaborative agreement with physician.

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New Hampshire

NP FPA · PA OTP

NPs FPA. PAs under 8,000 hrs at physician-free practices need collaboration (HB 1222, 2024).

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New Jersey

Reduced NP

Joint Protocol required. 2,400-hr partial FPA for primary care/BH APNs (2026 reform).

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New Mexico

NP FPA · PA Two-Tier

NPs FPA. PAs: collaborative vs. supervised — two-tier system. No legal liability for collaborating physician.

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New York

NP FPA · PA Collab

NPs fully independent (2023). PAs require collaborative agreement. No ratio cap.

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North Carolina

Restricted NP

Permanent NP supervision. Supervisory agreement filed with NCBON. No independence pathway.

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North Dakota

NP FPA · PA Independent

Both NPs and PAs practice independently. Voluntary physician consultation only.

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Ohio

Restricted NP · 5-APRN Cap

Standard Care Arrangement (SCA). 5-APRN cap. OARRS provisions required. No independence pathway.

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Oklahoma

NP & PA 6,240-hr Pathway

HB 2298 & HB 2584 (2025). Physician required until 6,240 hrs for both NPs and PAs. 6-combined cap.

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Oregon

NP FPA · PA Collab

NPs fully independent. PAs require collaborative agreement. No legal liability for physician.

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Pennsylvania

Restricted NP

Permanent NP collaboration. Collaborative agreement and prescriptive authority agreement required.

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Rhode Island

NP FPA · PA Collab

NPs FPA. PAs require physician collaboration. Scope at practice level. Schedule II–V prescribing.

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South Carolina

Restricted NP

Permanent NP collaboration. Practice agreement required. Specialty matching required.

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South Dakota

Reduced NP · PA Pathway

NP and PA experience-based pathways to independence. Physician collaboration during transition.

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Tennessee

Restricted NP · 20% Monthly

Permanent NP. 20% chart review every 30 days. Biannual in-person meetings. TN BON notice filed.

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Texas

Restricted NP · 7-NP Cap

Permanent NP delegation. Prescriptive Authority Agreement. 7-NP cap. TMB and BON dual filing.

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Utah

NP FPA · PA Three-Tier

NPs FPA (SB 36, 2023). PAs: three-tier system — under 4,000 and 4,000–9,999 hrs need physician.

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Vermont

NP FPA · PA Collab

NPs fully independent. PAs require collaborative agreement with physician.

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Virginia

Restricted NP

Permanent NP collaboration. Practice agreement on file. Same specialty required.

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Washington

NP FPA · PA Collab

NPs fully independent. PAs require collaboration agreement (2025 reform). Under 4,000 hrs supervised.

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West Virginia

Restricted NP

Permanent NP collaboration. Collaborative practice agreement required. No independence pathway.

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Wisconsin

Restricted NP

Permanent NP collaboration required. Collaborative agreement on file. No independence pathway.

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Wyoming

Full Independence

Both NPs and PAs fully independent. No physician collaboration required (SF 0033, 2022).

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