A summary of Maryland’s collaboration, agreement, filing, supervision, prescribing, and specialty rules for NPs and the physicians who collaborate with them.
Collaborating Physician Required? Yes, for new NPs. Otherwise, no.
Physician Involvement: Low
Agreement Name: None
On-Site Requirements: None
Chart Review: Not required
Controlled Substances: Allowed
Reduced Supervision / Transition Requirements: Independent practice after an 18-month mentorship (new NPs only); NPs certified in another state are exempt from the outset.
Maryland NP Collaboration Requirements Summary
Maryland requires a collaborating clinician only for brand-new NPs, and only for 18 months. A first-time NP — one never certified in Maryland or any other state — must identify a mentor (a Maryland-licensed NP or physician with at least three years’ experience) who is available for consultation for 18 months; NPs already certified elsewhere are exempt entirely, and there is no formal written agreement. After 18 months, the NP practices independently. This page summarizes Maryland’s collaboration, agreement, filing, supervision, prescribing, and specialty rules for NPs and the physicians who collaborate with them.
Source: Md. Health Occ. Code § 8-302.1(d)(1)
Type of Collaborative Relationship
Maryland requires a collaborating clinician only for brand-new NPs, for their first 18 months. A first-time NP (never certified in any state) must identify a mentor — a Maryland-licensed NP or physician with at least three years of clinical experience — available for advice, consultation, and collaboration as needed; NPs already certified in another state are exempt. Maryland sets no ratio limit, meeting cadence, chart-review count, or on-site requirement, and after 18 months the NP practices independently.
Source: Md. Health Occ. Code § 8-302.1(d)(1)
What is an NP’s scope of practice in Maryland?
Maryland NPs (certified nurse practitioners) practice independently within their role, with a brief mentorship required only for brand-new NPs. A first-time NP works with a mentor for their first 18 months; after that, they practice with full authority.
Do NPs need a collaborating physician in Maryland?
Only new NPs, and not necessarily a physician. A first-time NP (never certified in any state) must identify a mentor — a Maryland-licensed NP or physician — for 18 months. NPs already certified in another state do not need a mentor at all, even if they have practiced less than 18 months.
Can NPs practice independently in Maryland?
Yes. Maryland NPs practice independently once any required 18-month mentorship is complete, and NPs certified in another state practice independently from the start.
How many NPs can a physician supervise in Maryland?
There is no limit. Maryland sets no ratio cap on how many NPs a mentor may work with.
Who can be a collaborating physician in Maryland?
A mentor may be a certified NP or a physician licensed in Maryland and in good standing, with at least three years of clinical practice experience, who is available for advice, consultation, and collaboration as needed. A physician is not required — an experienced NP can serve.
Are there proximity or in-person requirements in Maryland?
No, Maryland sets no geographic, travel, or on-site presence requirement.
Collaboration Agreement Requirements
Maryland does not require a written collaborative agreement. A first-time NP simply identifies a mentor — including the mentor’s name and license number — on the certification application; there is no state template and no required content, signatures, storage, backup, or review.
Source: Code of Md. Regs. 10.27.07.01
What must be included in an NP collaborative agreement in Maryland?
No agreement is required. Maryland does not mandate a written collaborative agreement; a first-time NP only identifies a mentor on the certification application (including the mentor’s name and license number).
What is the collaborative agreement called in Maryland?
There is no named agreement. Maryland requires a mentor relationship rather than a formal collaborative agreement.
Who has to sign the collaborative agreement in Maryland?
No one. Maryland sets no signature requirement, because no written agreement is required.
How often must the agreement be reviewed or renewed in Maryland?
There is no review or renewal requirement, since Maryland does not require a written agreement.
Is a backup physician required in Maryland?
No, Maryland does not require a backup physician.
Board Filing Requirements
Maryland does not require a collaborative agreement to be filed, but a first-time NP must name their mentor on the certification application. There are no recurring filing or termination-notice requirements, and no separate application is needed to move to independent practice after the 18 months.
Source: Code of Md. Regs. 10.27.07.01
Do you have to file the collaborative agreement with the board in Maryland?
No agreement is filed, but a first-time NP must identify their mentor — name and license number — on the certification application.
Can an NP start practicing as soon as they file in Maryland?
An NP may practice once the Board grants certification. Filing alone is not enough — licensure must be granted first.
What are the termination and notice requirements in Maryland?
Maryland sets no termination-notice requirement, and no separate filing is needed to move to independent practice once the 18-month mentorship is complete.
Collaboration Compliance
Maryland imposes almost no ongoing mentorship obligations. There is no required meeting cadence, chart review, chart co-signing, or documentation; the mentor need only be available for advice, consultation, and collaboration as needed during the 18 months.
Source: Code of Md. Regs. 10.27.07.01
How many charts must a collaborating physician review in Maryland?
There is no fixed number. Maryland does not require chart review or chart co-signing.
How often must an NP and collaborating physician meet in Maryland?
There is no set cadence. Maryland does not require scheduled meetings. The mentor must simply be available for advice, consultation, and collaboration as needed.
How long must collaboration records be kept in Maryland?
Maryland sets no recordkeeping or retention requirement for the mentorship.
Prescribing Rules
Maryland NPs may prescribe, including controlled substances, without a separate state DEA registration, but controlled-substance prescribing carries PDMP obligations. NPs must enroll in the Prescription Drug Monitoring Program (PDMP) before obtaining or renewing a Maryland Controlled Dangerous Substances (CDS) Registration, and must query the PDMP before prescribing opioids or benzodiazepines.
Source: Code of Md. Regs. 10.27.07
Can an NP prescribe controlled substances in Maryland?
Yes. Maryland NPs may prescribe controlled substances; they must enroll in the PDMP before obtaining or renewing a Maryland CDS Registration and query the PDMP before prescribing opioids or benzodiazepines (and at least every 90 days while the patient continues on them).
Can an NP prescribe Schedule II drugs in Maryland?
There is no Schedule II–specific rule for Maryland. NPs may prescribe controlled substances subject to holding a Maryland CDS Registration and meeting PDMP requirements.
What schedule drugs can an NP prescribe in Maryland?
Maryland NPs may prescribe schedule II – V drugs.
Does an NP need a DEA license in Maryland?
Maryland does not require a separate state DEA registration. For controlled substances, NPs obtain a Maryland Controlled Dangerous Substances (CDS) Registration (from the Division of Drug Control) and must be enrolled in the PDMP before obtaining or renewing it.
Can an NP prescribe independently in Maryland?
Yes. Maryland does not require a mentor or physician to co-sign prescriptions; NPs prescribe under their own authority, and after any 18-month mentorship they practice fully independently.
Specialty & Telehealth Requirements
Maryland sets no telehealth-specific or specialty-specific collaboration requirements.
Source: Code of Md. Regs. 10.27.07
Are there telehealth or telemedicine requirements for NPs in Maryland?
No, Maryland sets no telehealth-specific collaboration requirements.
Are there specialty-specific requirements for NPs in Maryland?
No, Maryland sets no specialty-specific requirements.
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