Oklahoma NP Collaboration Requirements Summary

Oklahoma nurse practitioners must have a collaborating physician in order to prescribe medications. Oklahoma also provides a path to independent prescriptive authority after 6,240 hours. Oklahoma requires a supervising physician (its term for the collaborating physician) and a written supervision agreement specifically for prescriptive authority; non-prescribing practice does not require one. Physician involvement is standard: continuous availability, regular review of the NP’s prescribing patterns, and accepted responsibility for the NP’s prescribing, with no fixed meeting or chart-review count.

Source: Okla. Stat. Ann. tit. 59 § 479.1

Type of Collaborative Relationship

Oklahoma NPs need a supervising physician — the state’s term for the collaborating physician — in order to prescribe, and there is a path to independent prescriptive authority after 6,240 hours. The requirement applies to prescriptive authority only, not to non-prescribing practice. Physician involvement is standard: the physician must be continuously available (in person or electronically), regularly review the NP’s prescribing patterns, and accept responsibility for the NP’s prescribing.

Source: Okla. Stat. Ann. tit. 59 § 479.1

What is an NP’s scope of practice in Oklahoma?

Oklahoma NPs (advanced practice registered nurses) practice within their recognized role and, to prescribe, must do so under a supervising physician and a written supervision agreement. A supervising physician is required specifically for prescriptive authority, until the NP earns independent prescriptive authority.

Do NPs need a collaborating physician in Oklahoma?

Yes, to prescribe. Oklahoma NPs must have a supervising physician (Oklahoma’s term for the collaborating physician) and a written supervision agreement to hold prescriptive authority; this applies to prescribing only, and no longer applies once the NP obtains independent prescriptive authority.

Can NPs practice independently in Oklahoma?

Yes for prescribing, after meeting the requirements. An NP who completes 6,240 clinical practice hours with physician-supervised prescriptive authority may apply to the Board of Nursing for independent prescriptive authority. Non-prescribing practice does not require a supervising physician.

How many NPs can a physician supervise in Oklahoma?

Up to six. A physician may supervise no more than six physician assistants and/or NPs combined with respect to prescriptive authority, though the Board may grant an exception on request.

Who can be a collaborating physician in Oklahoma?

A physician who is trained and fully qualified in the NP’s specialty, holds valid federal DEA and Oklahoma Bureau of Narcotics (OBNDD) controlled-substance registrations, and is in active clinical practice with at least 20 hours per week of direct patient contact. The physician need not practice in Oklahoma. For a certified nurse-midwife, the supervising physician may be a family practice physician, obstetrician, or gynecologist.

Are there proximity or in-person requirements in Oklahoma?

No, Oklahoma sets no geographic or travel requirement, and the supervising physician need not be located in Oklahoma.

Collaboration Agreement Requirements

Oklahoma’s written agreement is called a supervision agreement, and the state provides a template. It must specify any fees charged to the NP for supervision, the scope of the NP’s prescriptive authority, the extent of supervision required, the supervising physician’s duties and responsibilities, how the physician will notify the NP of absences, and one or more backup (alternate) physicians.

Source: Okla. Stat. Ann. tit. 59 § 479.1(C)

What must be included in an NP collaborative agreement in Oklahoma?

It must specify any supervision fees charged to the NP (not applicable if the employer pays), the scope of the NP’s prescriptive authority, the extent of supervision required, the supervising physician’s duties and responsibilities, how the physician will give notice of absences, and one or more backup physicians.

What is the collaborative agreement called in Oklahoma?

It is called a supervision agreement — Oklahoma’s term for the written prescriptive-authority agreement between an NP and a supervising physician.

Who has to sign the collaborative agreement in Oklahoma?

Oklahoma sets no explicit signature requirement.

How often must the agreement be reviewed or renewed in Oklahoma?

Oklahoma sets no fixed review or renewal requirement for the agreement itself, but it is submitted with the NP’s prescriptive-authority application at each renewal, and any change must be filed within 30 days.

Is a backup physician required in Oklahoma?

Yes. The supervision agreement must designate one or more alternate physicians to supervise the NP during the supervising physician’s absences.

Board Filing Requirements

Oklahoma requires the supervision agreement to be filed with both boards for prescriptive authority. The NP submits it with the initial prescriptive-authority application and each renewal to the Board of Nursing, and the supervising physician files it with their own board (Medicine or Osteopathic). Changes must be filed within 30 days and take effect on filing.

Source: Okla. Stat. Ann. tit. 59 § 567.4a(1)

Do you have to file the collaborative agreement with the board in Oklahoma?

Yes. The NP files the supervision agreement with the Board of Nursing as part of the prescriptive-authority application and each renewal, and the supervising physician files it with their respective board (Medicine or Osteopathic).

Can an NP start practicing as soon as they file in Oklahoma?

Yes, except when it is part of an initial application for prescriptive authority. Changes to supervising physicians take effect upon filing (within 30 days of the change), but initial prescriptive authority requires the application to be granted first.

What are the termination and notice requirements in Oklahoma?

The supervising physician must notify their board — and all supervised NPs — of any change to the supervising relationship within 30 days, including adding or removing an NP. Changes are filed with the board within 30 days and are effective on filing; the Board of Nursing also lets NPs remove collaborators through the portal.

Collaboration Compliance

Oklahoma’s ongoing obligations center on availability and prescribing oversight rather than fixed counts. The supervising physician must be continuously available (in person or electronically) for consultation, emergencies, or referral, and must regularly and routinely review the NP’s prescribing patterns. There is no required meeting cadence, chart-review count, chart co-signing, or documentation requirement.

Source: Okla. Admin. Code 435:10-13-2

How many charts must a collaborating physician review in Oklahoma?

No fixed number. Oklahoma sets no chart review count and does not require chart co-signing. The supervising physician must, however, regularly and routinely review the NP’s prescribing practices and patterns.

How often must an NP and collaborating physician meet in Oklahoma?

No set cadence. Oklahoma does not require scheduled meetings. It requires appropriate consultation, collaboration, and referral, plus continuous availability of the supervising physician by direct or electronic communication.

How long must collaboration records be kept in Oklahoma?

Oklahoma sets no specific recordkeeping or retention requirement for the supervision relationship.

Prescribing Rules

Oklahoma NPs with prescriptive authority may prescribe within the Board of Nursing formulary, but controlled-substance authority is limited: Schedules III–V only, capped at a 30-day supply, and NPs may not prescribe Schedule I or II. Controlled-substance prescribing requires both a federal DEA registration and an Oklahoma Bureau of Narcotics and Dangerous Drugs (OBNDD) registration.

Source: Okla. Admin. Code 485:10-16-5(c)

Can an NP prescribe controlled substances in Oklahoma?

Yes, but only Schedules III–V. An NP with prescriptive authority may prescribe Schedule III–V controlled substances in up to a 30-day supply. NPs may not prescribe Schedule I or II drugs.

Can an NP prescribe Schedule II drugs in Oklahoma?

No. Oklahoma NPs may not prescribe Schedule II drugs.

What schedule drugs can an NP prescribe in Oklahoma?

Oklahoma NPs may prescribe non-controlled drugs on the Board of Nursing formulary and controlled substances in Schedules III–V (up to a 30-day supply). They may not prescribe Schedule I or II.

Does an NP need a DEA license in Oklahoma?

Yes, for controlled substances. An NP prescribing Schedule III–V drugs must comply with federal DEA requirements and also hold an Oklahoma Bureau of Narcotics (OBNDD) registration.

Can an NP prescribe independently in Oklahoma?

Yes, after earning independent prescriptive authority. An NP who completes 6,240 supervised clinical practice hours with prescriptive authority may apply for independent prescriptive authority and then prescribe without a supervising physician.

Specialty & Telehealth Requirements

Oklahoma sets no telehealth-specific or specialty-specific collaboration requirements.

Source: Okla. Stat. Ann. tit. 59 § 479.1(H)

Are there telehealth or telemedicine requirements for NPs in Oklahoma?

No, Oklahoma sets no telehealth-specific collaboration requirements.

Are there specialty-specific requirements for NPs in Oklahoma?

No, Oklahoma sets no specialty-specific requirements. The supervising physician must be trained and fully qualified in the NP’s specialty (for a certified nurse-midwife, that may be a family practice physician, obstetrician, or gynecologist).