A summary of Kentucky’s collaboration, agreement, filing, supervision, prescribing, and specialty rules for NPs and the physicians who collaborate with them.
Collaborating Physician Required? Yes
Physician Involvement: Low, and transitions to Independent at 4 years
Agreement Name: Two agreements: the CAPA-NS (for non-controlled, “nonscheduled legend” drugs) and the CAPA-CS (for controlled substances).
On-Site Requirements: None
Chart Review: No requirement.
Controlled Substances: Allowed with a CAPA-CS, a U.S. DEA registration, and PDMP enrollment and queries.
Reduced Supervision / Transition Requirements: Four years of practice/prescribing experience
Kentucky NP Collaboration Requirements Summary
Kentucky nurse practitioners must have a collaborating physician in order to prescribe. There is also a path to prescribing independently after four years. Kentucky ties collaboration to prescriptive authority through two written agreements: a CAPA-NS to prescribe non-controlled (“nonscheduled legend”) drugs and a CAPA-CS to prescribe controlled substances. Physician involvement is low for non-controlled prescribing but greater for controlled substances, which carry required collaboration meetings and PDMP review. After four years of prescribing, an NP can qualify to prescribe without an agreement.
Source: Ky. Rev. Stat. § 314.042
Type of Collaborative Relationship
Kentucky NPs need a collaborating physician to prescribe, and how involved that physician must be depends on what the NP prescribes. Prescribing non-controlled drugs requires a CAPA-NS with light involvement — no meetings, chart review, or on-site presence — while prescribing controlled substances requires a CAPA-CS with required collaboration meetings. After four years of prescribing, an NP can be exempt from the agreement and prescribe independently.
Source: Ky. Rev. Stat. § 314.042
What is an NP’s scope of practice in Kentucky?
Kentucky NPs (advanced practice registered nurses) practice within their population focus, and a collaborating physician is required specifically for prescribing. An NP needs a CAPA-NS to prescribe non-controlled prescription drugs and a CAPA-CS to prescribe controlled substances, until qualifying to prescribe independently after four years.
Do NPs need a collaborating physician in Kentucky?
Yes, to prescribe. Kentucky NPs must have a collaborating physician through a prescriptive-authority agreement — a CAPA-NS for non-controlled drugs and a CAPA-CS for controlled substances — unless they have completed four years of prescribing and obtained an exemption.
Can NPs practice independently in Kentucky?
Yes, after four years. An NP can prescribe non-controlled drugs without a CAPA-NS after four years of prescribing, and controlled substances without a CAPA-CS after four years of controlled-substance prescribing. Each requires notifying the Board first.
How many NPs can a physician supervise in Kentucky?
No limit — Kentucky sets no collaboration ratio cap on how many NPs a physician may collaborate with.
Who can be a collaborating physician in Kentucky?
A physician licensed in Kentucky who is qualified in the same or a similar specialty as the NP. An NP who has full prescriptive authority (completed four years and no longer needs an agreement) may also serve as the collaborator.
Are there proximity or in-person requirements in Kentucky?
No — Kentucky sets no geographic, travel, or on-site presence requirement, and collaboration may be remote.
Collaboration Agreement Requirements
Kentucky uses two standardized, required state forms — the CAPA-NS for prescribing non-controlled drugs and the CAPA-CS for controlled substances. Each must list the name, practice address, phone number, and license number of the NP and every physician party, plus the population focus and area of practice; the CAPA-CS must additionally define the scope of controlled-substance prescribing, describe the collaboration and communication arrangement, and state any agreed prescribing limits. Both must be signed by the NP and the collaborating physician, and a signed copy must be kept at each practice site.
Source: Ky. Rev. Stat. § 314.042(15)
What must be included in an NP collaborative agreement in Kentucky?
Both agreements must include the name, practice address, phone number, and license number of the NP and each physician party, plus the population focus and area of practice. The controlled-substance agreement (CAPA-CS) must also define the scope of controlled-substance prescriptive authority, describe how the NP and physician will collaborate and communicate about it, and state any agreed limits on what the NP may prescribe.
What is the collaborative agreement called in Kentucky?
Kentucky uses two: the CAPA-NS (Collaborative Agreement for the APRN’s Prescriptive Authority for nonscheduled legend drugs) and the CAPA-CS (the same agreement, for controlled substances).
Who has to sign the collaborative agreement in Kentucky?
Both the NP and the collaborating physician must sign it — this applies to both the CAPA-NS and the CAPA-CS.
How often must the agreement be reviewed or renewed in Kentucky?
Kentucky sets no review or renewal requirement for the agreement itself, but the NP must report any change to a CAPA-NS or CAPA-CS to the Board within 30 days.
Is a backup physician required in Kentucky?
No, Kentucky does not require a backup physician.
Board Filing Requirements
Kentucky requires notification rather than pre-approval to begin prescribing under an agreement: the NP notifies the Board that a CAPA-NS or CAPA-CS exists (and names the collaborating physician) through the KBN Nurse Portal, and may begin once that notification is filed. There are no recurring filing requirements, but changes must be reported within 30 days. Prescribing controlled substances without an agreement is the exception — that requires the Board to complete an exemption review and notify the NP in writing first.
Source: Ky. Rev. Stat. § 314.042(12)
Do you have to file the collaborative agreement with the board in Kentucky?
Only notification is required, not the full agreement up front. The NP notifies the Board through the KBN Nurse Portal that a CAPA-NS or CAPA-CS exists and names the collaborating physician, then furnishes a copy of the agreement only if the Board requests it.
Can an NP start practicing as soon as they file in Kentucky?
Yes, for prescribing under an agreement — only notification is required, so the NP can begin once it is submitted. Prescribing controlled substances without an agreement is different: the Board must complete its exemption review and notify the NP in writing before the NP may proceed.
What are the termination and notice requirements in Kentucky?
Either party may rescind a CAPA-NS or CAPA-CS with written notice to the other party and the Board, and the NP must report the change within 30 days. If an agreement ends unexpectedly for reasons outside the NP’s control, the NP may keep prescribing for up to 30 days after documenting the justification in each patient’s record.
Collaboration Compliance
Kentucky’s ongoing obligations apply mainly to controlled-substance prescribing. There is no chart review count, no general meeting requirement, and no on-site availability standard for prescribing non-controlled drugs; but under a CAPA-CS, the NP and physician must hold collaboration meetings to review the NP’s PDMP queries and must keep written records of them.
Source: 201 KAR 20:057 Sec. 3
How many charts must a collaborating physician review in Kentucky?
No fixed number — Kentucky does not require chart review or chart co-signing. Under a controlled-substance agreement, the NP and physician must review the NP’s PDMP queries at their required collaboration meetings.
How often must an NP and collaborating physician meet in Kentucky?
No meeting is required for prescribing non-controlled drugs. For controlled substances under a CAPA-CS, the NP and physician must meet at least quarterly during the first year and at least twice a year in years 2–4; the rules give no guidance for year five and beyond.
How long must collaboration records be kept in Kentucky?
For controlled-substance collaborations, both the NP and physician must keep written records of their meetings for one year past the expiration of the CAPA-CS. Kentucky sets no separate recordkeeping requirement for non-controlled prescribing.
Prescribing Rules
Kentucky NPs may prescribe both non-controlled (“nonscheduled legend”) drugs and controlled substances, but each requires the applicable prescriptive-authority agreement until the NP earns an exemption. Prescribing controlled substances requires a CAPA-CS, a U.S. DEA registration with the Kentucky DEA number reported to the Board, PDMP enrollment and queries, and a written treatment plan for each patient.
Source: Ky. Rev. Stat. § 314.042
Can an NP prescribe controlled substances in Kentucky?
Yes, with a CAPA-CS. An NP may prescribe controlled substances under a Collaborative Agreement for Controlled Substances with a Kentucky physician in the same or a similar specialty, plus a DEA registration and PDMP participation — until the NP completes four years of controlled-substance prescribing and qualifies to prescribe them without an agreement.
Can an NP prescribe Schedule II drugs in Kentucky?
Yes. Kentucky NPs with a CAPA-CS may prescribe Schedules II through V controlled substances, subject to any limits agreed to in the CAPA-CS.
What schedule drugs can an NP prescribe in Kentucky?
Kentucky NPs may prescribe non-controlled (nonscheduled legend) drugs and, with a CAPA-CS, controlled substances in Schedules II through V. The CAPA-CS may impose limits stricter than the statutory schedules.
Does an NP need a DEA license in Kentucky?
Yes, for prescribing controlled substances.
Can an NP prescribe independently (without physician sign-off) in Kentucky?
Yes, Kentucky does not require physician sign-off or co-signing on individual prescriptions, and after four years of prescribing an NP can prescribe without any collaboration agreement. Until then, the NP prescribes under their own authority within the terms of the agreement.
Specialty & Telehealth Requirements
Kentucky sets no telehealth-specific collaboration requirement and no specialty-specific requirements. The one specialty-related rule is that the NP and collaborating physician must be qualified in the same or a similar specialty.
Source: 201 KAR 20:057 Sec. 6
Are there telehealth or telemedicine requirements for NPs in Kentucky?
No, Kentucky sets no telehealth-specific requirements.
Are there specialty-specific requirements for NPs in Kentucky?
The NP and collaborating physician must be qualified in the same or a similar specialty, and the four years of prescribing experience needed for independence must be earned within the NP’s population focus.
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