A physician-maintained reference on what each state actually requires — capacity limits, on-site presence, chart review, controlled substance authority, and how long approval takes.
Most comparison tables you'll find are compiled from other comparison tables. This one is built state by state from primary sources and from practice, reviewed by a physician who holds licences in 45 states and has personally activated collaborations in many of them.
Which also means it's honest about its own limits. States marked Reviewed have been checked against the relevant boards and carry a review date. States marked In progress aren't published yet rather than guessed at. If a state you need isn't here, ask us — we can usually answer directly, and it moves that state up the queue.
Capacity limits are often measured in hours, not people. Texas caps at 7 FTEs, which means 280 supervised hours per week — so a physician may cover more than seven part-timers. Alabama works the same way at 360 hours. The right question for a prospective collaborator is usually "how many hours per week do you already carry?" rather than "how many providers do you have?"
"No cap" doesn't mean no limit. States without a numeric cap still expect genuine availability. A physician stretched across twenty NPs may satisfy the arithmetic and fail the standard.
Requirements change most legislative sessions. Every entry carries a review date. If it's more than six months old, treat it as a starting point rather than an answer.
| State | NP needs a collaborator? | Capacity limit | On-site required? | Chart review | Schedule II | Reviewed |
|---|---|---|---|---|---|---|
| Texas | Yes — prescriptive authority agreement | 7 FTEs combined NP+PA = 280 hrs/week; part-time counts proportionally; medically underserved hours excluded; facility-based hospital exempt | No — reachable by phone suffices | Set by QA plan; no fixed % | Permitted | Sep 2026 |
| Pennsylvania | Yes — career-long; plus a backup physician | No NP cap; 6 PAs per physician | No | Not required | Permitted under own authority | Sep 2026 |
| Florida | Not if autonomously registered (3,000 hrs; primary-care oriented) | 4 primary-care / 2 specialty offices remotely; no NP headcount cap; 10 PAs | No | Not required | Yes, 7-day supply cap — except psychiatric meds by psychiatric nurses | Sep 2026 |
| Ohio | Yes — Standard Care Arrangement | 5 prescribing APRNs per physician; 5 PAs; no cap on non-prescribing | No | Annual review | Restricted — 72-hr supply + terminal condition unless practice-site exception applies | Sep 2026 |
| New York | Yes (under 3,600 hrs); independent practice at 3,600+ hrs | 4 NPs at different locations; no cap same location | No | Quarterly minimum, no fixed % | Permitted | Sep 2026 |
| Alabama | Yes — joint ABME/ABN approval | 360 hrs/week across CRNPs, CNMs & PAs | Yes — 10% of scheduled hours if under 2 yrs/4,000 hrs. Local back-up physician may cover it; virtual practices exempt | Meaningful sample per QA plan; quarterly | Requires QACSC + LPSP permits and an agreed formulary | Sep 2026 |
| New Jersey | Yes — joint protocol until 5,000+ hrs (S2996, signed 30 Mar 2026). Independent practice covers primary or behavioural health; excludes general OB & cosmetic | No cap | No | No set percentage, but the protocol must specify review frequency & methodology; annual protocol review | Permitted. NJ CDS registration required alongside DEA — addresses must match | Sep 2026 |
| Illinois | Yes — written collaborative agreement until full practice authority (4,000 hrs post-certification + 250 hrs CE). Hospital/ASTC practice exempt via clinical privileges | No cap | No | Not required — no set percentage; standard agreement provides for a monthly Schedule II discussion | Schedules II–V. Even with FPA, some Sch. II and IV medications need a physician consultation relationship; those Sch. II medications oral/topical/transdermal only. State CS licence required before DEA | Sep 2026 |
| Mississippi | Yes — both boards must approve site, physician and agreement before you practise. Backup coverage required, or protocol terms that no patients are seen when the primary is unavailable | 4 primary agreements (waiver needed beyond), plus up to 4 as secondary collaborator | Yes — the strictest here. 40–75 miles, beyond which "Extended Mileage" needs a Board appearance. In practice most arrangements need a waiver or the Primary Care exemption (4 conditions; mental health counts as primary care) | 10% or 20 charts, whichever is less, monthly + a review log; quarterly face-to-face meetings | Permitted under protocol, subject to MS controlled substance rules | Sep 2026 |
| Tennessee | Yes — certificate of fitness + filed Notice & Formulary; no independent pathway | No numeric cap — tied to the physician's ability to meet the review duties | No | 20% of charts every 30 days; controlled-substance review within 10 days | Schedules II–V with own DEA; Sch. II & III pain medications capped at a non-refillable 30-day course unless approved after consultation | Sep 2026 |
| Indiana | Yes — CPA filed with the Board; authority must be issued before prescribing. Agreement must list every other practice agreement both parties hold | No cap | No mileage rule; the agreement addresses "proximity" as a term | 5% random sampling, submitted to the physician within 7 days — lightest sample here, tightest clock | Permitted, limits set in the agreement. Indiana CSR ($60) required for the prescriber, plus one per storage location; not required of the physician | Sep 2026 |
| Kentucky | Yes — CAPA-NS (legend drugs) and/or CAPA-CS (Sch. II–V). Both end after 4 years of prescribing — NS by notification, CS by application | No cap | No | No percentage — instead KASPER review meetings: quarterly in yr 1, biannual in yrs 2–4, documented | Schedules II–V under a CAPA-CS; limits set in the agreement, not by statute. First-year CAPA-CS requires employment | Sep 2026 |
| Louisiana | Yes — LSBN written approval before practising; CPA must use the Board's template | No cap | No mileage rule, but the physician must be actively practising in Louisiana in a comparable specialty | Not required — no set percentage; Board may audit records at random | Requested by tier: III–V, Sch. II, ADHD category, or full Sch. II incl. pain medications. State CDS licence required before DEA, whole chain inside 60 days | Sep 2026 |
| Missouri | Yes — collaborative practice arrangement; no independent pathway | 6 FTEs combined APRNs, PAs & assistant physicians | No — 75-mile definition rescinded 2024, but statutory "geographic proximity" survives; waiver available (45-day default approval) | 10% of services + 20% of controlled-substance cases, every 14 days — the most demanding here | One Schedule II medication only (120-hr, no refill), III–V; other Sch. II physician-only. BNDD registration required before DEA | Sep 2026 |
| North Carolina | Yes — collaborative practice agreement, joint board approval before seeing patients | No numeric cap — "adequate supervision" standard instead | No | No mandated % — but a written ongoing review process required. Meetings monthly for 6 months, then every 6 months; restarts on physician change | Permitted — own DEA; physician must hold equivalent schedules | Sep 2026 |
| Virginia | Yes — practice agreement until autonomous (equiv. 3 yrs full-time; reduced from 5 in Jul 2024) | 6 APRNs — but 10 where they're psychiatric-mental health APRNs. No PA cap | No | Not required for NPs. PA agreements must specify a review timeframe | Schedules II–VI permitted | Sep 2026 |
| California | Yes — Standardized Procedure Agreement, unless certified 103 (group setting w/ a physician, 3 yrs + 4,600 hrs) or 104 (independent in defined settings, 3 more yrs) | 4 prescribing NPs; 8 PAs (raised from 4 on 1 Jan 2026). 103/104 NPs don't count | No | Not required — no state percentage; PA countersignature eliminated | Permitted — furnishing number + DEA. CURES registration mandatory | Sep 2026 |
Alabama is the only one requiring physical presence — 10% of scheduled hours for newer NPs. Everywhere else, reachable by phone satisfies the standard. That single difference determines whether a remote collaborator is viable.
Ohio is the most restrictive on Schedule II by a wide margin. The default rule — terminal condition, physician-initiated, 72-hour supply — makes ordinary outpatient prescribing impossible unless you fall under a practice-site exception.
Florida's psychiatric exemption is unusual. The 7-day Schedule II cap doesn't apply to psychiatric medications prescribed by psychiatric nurses, which makes Florida meaningfully easier for PMHNPs than for other specialties.
Pennsylvania is the only one requiring a second physician. The backup physician requirement is easy to miss and stalls people mid-process.
New York and New Jersey both use hours-based thresholds, moving in the same direction. New York exempts NPs past 3,600 hours from the written agreement requirement. New Jersey went the same way in March 2026, exempting APNs past 5,000 hours. Both provisions have carried statutory expiration dates and have been extended — confirm current status with each state's licensing board before relying on either.
Read review requirements as a percentage and a clock. Tennessee's 20% monthly and Missouri's 10% fortnightly are heavy samples on a slow beat. Indiana's 5% within seven days is the lightest sample in the table on the tightest turnaround — a weekly habit rather than a scheduled task, and it lapses differently. The percentage alone tells you very little about what a physician is actually signing up for.
Missouri asks the most of the physician, by a wide margin. 10% of all charts and 20% of controlled-substance charts, every fourteen days, written into both statute and regulation. Most states leave review to the agreement; Missouri sets a number and a clock. It's also the only state here where the provider's controlled-substance authority terminates immediately if the physician's does.
Three states won't let you start. North Carolina requires joint approval from both boards before you see a patient, and the clock restarts if your physician changes. Louisiana requires written LSBN approval of your physician first. Mississippi requires site, physician and agreement all approved. Everywhere else, a signed agreement lets you begin — sometimes with a filing due later.
Several states require a state controlled-substance registration on top of the DEA — California (CURES), Missouri (BNDD), New Jersey (CDS), Illinois and Louisiana — and in Missouri, Illinois and Louisiana the state credential must come first. Doing it in the wrong order is the most common avoidable delay in this table.
Ask whose credential it is, too. Missouri requires the arrangement to name a current state controlled-substance registrant as the collaborating physician, and North Carolina requires the supervising physician to hold registration for the equivalent schedules — so in those states the physician's own credentials can disqualify them. Louisiana asks nothing of the physician beyond an active Louisiana medical practice.
Mississippi is the hardest approval here, and the only one where the waiver is the normal route rather than the exception. Both boards must approve before you see a patient; a 40–75 mile radius, a four-agreement cap per physician, and a small pool of willing collaborators combine to make a compliant in-radius match unavailable for most NPs. The Primary Care exemption removes the mileage restriction outright for arrangements meeting four conditions — and mental health counts as primary care, which puts psychiatric arrangements through a door most people never find.
Kentucky has the cleanest exit here, and it covers controlled substances. Both agreements end after four years of prescribing — the non-scheduled one by notifying the Board, the controlled substances one by application. Most states either require collaboration indefinitely or gate independence behind a threshold few reach. Nothing prompts you at four years, though: the exit exists, you have to go and take it.
Illinois shows why "full practice authority" needs reading closely. An Illinois APRN with FPA drops the written agreement — but still needs a physician consultation relationship for Schedule IV anti-anxiety medications and certain Schedule II medications. For psychiatric practice, independence on paper and independence in prescribing are not the same thing, and this is the clearest example of the gap.
Virginia is the only state here with a specialty-specific cap. Six APRNs per physician normally, ten where they're psychiatric-mental health APRNs — written into statute. For PMHNPs that's a materially larger pool of physicians with capacity than the headline number suggests.
California moved in both directions at once. NPs gained a genuine independence pathway through the 103 and 104 categories — though it takes six years of qualifying practice to reach the top of it — while the PA supervision limit doubled from four to eight in January 2026. Most published guidance still describes the old numbers.
These are drafted or queued, and will be published as they're reviewed:
Next up: Georgia · South Carolina
Need a state that isn't listed? Tell us which one. We answer directly, and it moves that state up the queue.