A summary of Mississippi's collaboration, agreement, filing, supervision, prescribing, and specialty rules for NPs and the physicians who collaborate with them.
Collaborating Physician Required? Yes
Physician Involvement: High
Agreement Name: Protocol (also called a collaborative agreement)
On-Site Requirements: The NP must practice within 75 miles of the collaborating physician; beyond this distance requires Board approval.
Chart Review: 10% or 20 charts, whichever is fewer, each month.
Controlled Substances: Allowed (Schedules II–V) after a board-approved education program and separate controlled-substance authorization; requires a federal DEA registration and use of the state PMP.
Reduced Supervision / Transition Requirements: None
Mississippi NP Collaboration Requirements Summary
Mississippi nurse practitioners must practice with a collaborating physician (or a dentist, for CRNAs) under a board-approved protocol. The state offers no pathway to independent practice. Physician involvement is high: the collaborating physician reviews the NP’s charts monthly, meets with the NP quarterly, and runs a formal quality-assurance program. NPs must generally practice within 75 miles of the collaborating physician unless an Extended Mileage arrangement is approved.
Source: Miss. Code Ann. 73-15-20
Type of Collaborative Relationship
Mississippi NPs must practice within a collaborative/consultative relationship with a physician (or, for CRNAs, a dentist) under a board-approved protocol, and there is no pathway to independent practice. Physician involvement is high — the collaborating physician reviews charts monthly, meets with the NP quarterly, and runs a formal quality-assurance program. There is no cap on how many NPs a physician may collaborate with, but distance and in-state-practice rules apply.
Source: Miss. Code Ann. 73-15-20(7)
What is an NP’s scope of practice in Mississippi?
Mississippi NPs (advanced practice registered nurses) practice within the functions authorized by the Nurse Practice Act, but only within a collaborative/consultative relationship with a physician (or dentist) and a board-approved protocol. An NP may not practice without both an active collaborative relationship and an approved protocol.
Do NPs need a collaborating physician in Mississippi?
Yes. Mississippi NPs must practice within a collaborative/consultative relationship with a physician (or a dentist, for CRNAs) under a board-approved protocol — this applies to practice generally, not just prescribing.
Can NPs practice independently in Mississippi?
No, Mississippi has no pathway to independent practice. NPs must maintain a collaborative relationship and an approved protocol at all times.
How many NPs can a physician supervise in Mississippi?
No limit. Mississippi sets no ratio cap on how many NPs a physician may collaborate with.
Who can be a collaborating physician in Mississippi?
A physician holding an unrestricted Mississippi license whose practice is compatible with the NP’s, and who practices within Mississippi at least 80 hours per month (20 hours per week) — not counting telemedicine or chart review. CRNAs may collaborate with a licensed dentist, and the Board may grant good-cause exceptions to the in-state requirement.
Are there proximity or in-person requirements in Mississippi?
Yes. The NP must generally practice within 75 miles of the collaborating physician. Beyond 75 miles (an “Extended Mileage Collaboration”), the physician must obtain Board approval by submitting a letter, unless the physician is in primary care, has direct access to the NP’s EMR, and practices in Mississippi at least 80 hours per month. Certain settings — hospitals, state health department facilities, federally qualified health centers, and volunteer clinics — are excluded from the distance rule.
Collaboration Agreement Requirements
Mississippi’s agreement is called a protocol (also referred to as a collaborative agreement), and the state provides a form for it. It must include a quality-assurance/quality-improvement program that spells out the monthly chart review, quarterly meeting, and documentation requirements; the expectations, practice permissions, and boundaries of the NP–physician relationship; and the specific practice sites. The quality-assurance program must be kept on site, and any backup collaborating physician must be a signatory to the protocol.
Source: 30 Miss. Admin. Code 2630(1.2)
What must be included in an NP collaborative agreement in Mississippi?
It must include a quality-assurance/quality-improvement program describing the monthly chart review, quarterly QA meeting, and documentation requirements; the expectations, practice permissions, and boundaries of the NP–physician relationship; and the specific practice sites.
What is the collaborative agreement called in Mississippi?
It is called a protocol (also referred to as a collaborative agreement), and Mississippi provides a state form for it.
Who has to sign the collaborative agreement in Mississippi?
Mississippi sets no general signature requirement for the protocol, but any backup collaborating physician must be a signatory to it.
How often must the agreement be reviewed or renewed in Mississippi?
Mississippi sets no fixed review cadence for the protocol itself, but it must be re-filed at license renewal and updated whenever the collaboration, protocol, or practice site changes.
Is a backup physician required in Mississippi?
Yes. The collaborating physician must ensure backup coverage when the primary collaborator is unavailable, and the backup physician must be a signatory to the protocol. If backup coverage cannot be secured, the protocol may instead state that no patients will be seen when the primary collaborator is unavailable.
Board Filing Requirements
Mississippi requires the protocol to be filed and approved before an NP can practice. The NP files the protocol with the Board of Nursing at license application, at renewal, when entering a new collaboration, and whenever the protocol or practice site changes; for collaborations where the NP practices more than 75 miles from the physician, the physician must also submit a letter and register the NP through the Medical Board’s online gateway. An NP may not practice without a board-approved protocol.
Source: Miss. Code Ann. 73-15-20(3)
Do you have to file the collaborative agreement with the board in Mississippi?
Yes. The NP files the protocol with the Board of Nursing at license application, renewal, when starting a new collaboration, and whenever the protocol or practice site changes. For Extended Mileage collaborations (NP practicing more than 75 miles from the physician), the physician must also submit a letter and register the NP through the Medical Board’s online gateway.
Can an NP start practicing as soon as they file in Mississippi?
No, board approval is required. An NP may not practice without both an active collaborative relationship and a board-approved protocol.
What are the termination and notice requirements in Mississippi?
Both the NP and the physician must notify the board immediately of any change to the collaborative relationship, including adding, deleting, or modifying a collaborating physician. If the NP unexpectedly loses their collaborating physician (death, unexpected disability, or unexpected relocation), the NP may continue practicing for a 90-day grace period — with one possible 90-day extension — subject to approval by both the Board of Nursing and the Board of Medical Licensure.
Collaboration Compliance
Mississippi’s ongoing obligations are substantial and center on a formal quality-assurance program. The collaborating physician must review a random sample of the NP’s charts each month (10% or 20 charts, whichever is fewer), meet with the NP face-to-face once per quarter, and keep a documented log of the chart reviews and quarterly meetings. The NP must be able to communicate reliably with the physician while practicing.
Source: 30 Miss. Admin. Code 2630(1.8)
How many charts must a collaborating physician review in Mississippi?
A random sample of 10% or 20 charts, whichever is fewer, of the patients the NP sees each month. The sample should reflect the variety of patient types the NP sees, and a case the NP and physician consulted on during the month counts as one chart review.
How often must an NP and collaborating physician meet in Mississippi?
Once per quarter. The collaborating physician must meet face-to-face with the NP — in person or by video conferencing — each quarter for quality assurance, and the meeting must be documented.
How long must collaboration records be kept in Mississippi?
Mississippi does not set a specific retention period, but the physician must maintain a documented log of the charts reviewed and the quarterly meetings, and the quality-assurance program must be kept on site and available for board inspection.
Prescribing Rules
Mississippi NPs may prescribe once they hold prescriptive authority, and may prescribe controlled substances in Schedules II–V after completing a board-approved education program and receiving separate controlled-substance authorization. Controlled-substance prescribing requires a federal DEA registration and use of the state Prescription Monitoring Program.
Source: Miss. Code Ann. 73-15-20(8)
Can an NP prescribe controlled substances in Mississippi?
Yes. An NP may apply for controlled-substance prescriptive authority after completing a board-approved educational program; once authorized, the NP may prescribe controlled substances in Schedules II–V, using a federal DEA registration and the state Prescription Monitoring Program.
Can an NP prescribe Schedule II drugs in Mississippi?
Yes. NPs who have completed the board-approved program and received controlled-substance authorization may prescribe Schedules II through V.
What schedule drugs can an NP prescribe in Mississippi?
Authorized NPs may prescribe controlled substances in Schedules II–V (after the board-approved education program and controlled-substance authorization), plus non-controlled prescription drugs. Mississippi provides specific guidance for prescribing opioids, benzodiazepines, and diet medications.
Does an NP need a DEA license in Mississippi?
Yes, to prescribe controlled substances.
Can an NP prescribe independently in Mississippi?
No. Mississippi requires all NP practice, including prescribing, to occur under a collaborative relationship and a board-approved protocol. There is no independent practice pathway.
Specialty & Telehealth Requirements
Mississippi sets no telehealth-specific collaboration requirements. Its one specialty-specific note is that psychiatric-mental health NPs may collaborate with primary care physicians.
Source: 30 Miss. Admin. Code 2630
Are there telehealth or telemedicine requirements for NPs in Mississippi?
No, Mississippi sets no telehealth-specific collaboration requirements.
Are there specialty-specific requirements for NPs in Mississippi?
Yes, Psychiatric-mental health NPs are allowed to collaborate with primary care physicians. Otherwise, the general rule applies that the collaborating physician’s practice must be compatible with the NP’s.
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