A summary of Pennsylvania’s collaboration, agreement, filing, supervision, prescribing, and specialty rules for NPs and the physicians who collaborate with them.
Collaborating Physician Required? Yes
Physician Involvement: Standard
Agreement Name: Collaborative agreement, and prescriptive authority collaborative agreement when the NP prescribes
On-Site Requirements: None
Chart Review: Required as part of regular review, but no fixed number of charts is set
Controlled Substances: Allowed; requires prescriptive authority approval plus federal DEA registration (Schedule II up to a 30-day supply; Schedules III–IV up to a 90-day supply)
Reduced Supervision / Transition Requirements: None
Pennsylvania NP Collaboration Requirements Summary
Pennsylvania requires nurse practitioners (certified registered nurse practitioners, or CRNPs) to work under a written collaborative agreement with a collaborating physician. Pennsylvania is a collaborative-practice state: the physician does not have to be on-site, but must be immediately available by phone or other telecommunication and involved in the practice on a regular basis. There is no transition pathway to reduced supervision or independent practice.
Source: 49 Pa. Code 21.251
Type of Collaborative Relationship
Pennsylvania NPs must work with a collaborating physician who stays involved in the practice but does not need to be physically present. The physician must be immediately available to the NP by direct communication, radio, telephone, or other telecommunication, and must be available on a regularly scheduled basis for referrals and review. Pennsylvania sets no limit on how many NPs a physician may collaborate with and no geographic or travel requirement, and there is no pathway to reduced supervision over time.
Source: 49 Pa. Code 21.251; 63 Pa. Stat. 212(13)
What is an NP’s scope of practice in Pennsylvania?
Pennsylvania NPs (CRNPs) deliver health care services within the scope of their certified specialty while working in collaboration with a physician.
Do NPs need a collaborating physician in Pennsylvania?
Yes. Pennsylvania NPs must work under a written collaborative agreement with a collaborating physician.
Can NPs practice independently in Pennsylvania?
No. Pennsylvania requires NPs to collaborate with a physician and provides no pathway to independent practice or reduced supervision.
How many NPs can a physician supervise in Pennsylvania?
There is no limit. Pennsylvania sets no collaboration ratio capping how many NPs a physician may collaborate with.
Who can be a collaborating physician in Pennsylvania?
Pennsylvania sets no specific qualification requirements for a collaborating physician beyond being a licensed physician who enters the collaborative agreement.
Are there proximity or in-person requirements in Pennsylvania?
No. The physician does not have to be on-site; Pennsylvania requires only that the physician be immediately available by direct communication, radio, telephone, or other telecommunication. There is also no geographic or travel requirement.
Collaboration Agreement Requirements
The written agreement is called a collaborative agreement (or a prescriptive authority collaborative agreement when the NP will prescribe), and it must be signed by both the NP and the collaborating physician. The agreement must provide that the physician will be immediately available, set out a predetermined plan for emergency services, and provide that the physician is available on a regular basis for referrals, chart review, consultation, protocol review, and cosigning records when needed. When the NP will prescribe, the agreement must also identify the parties (including a substitute/back-up physician), the NP’s specialty, the categories of drugs the NP may prescribe, how often the physician will personally see the patient, and the amount of the NP’s professional liability insurance. The agreement must be kept at the NP’s primary practice location and reviewed at least every two years.
Source: 49 Pa. Code 21.251; 49 Pa. Code 21.285(a)
What must be included in an NP collaborative agreement in Pennsylvania?
The agreement must provide that the physician will be immediately available, include a predetermined plan for emergency services, and provide for regular referrals, chart review, consultation, protocol review, and cosigning of records when needed. When the NP prescribes, it must also name the parties (including a backup physician), the NP’s specialty, the categories of drugs the NP may prescribe, how often the physician will see the patient, and the NP’s professional liability insurance amount.
What is the collaborative agreement called in Pennsylvania?
It is called a collaborative agreement — or, when the NP has prescriptive authority, a prescriptive authority collaborative agreement.
Who has to sign the collaborative agreement in Pennsylvania?
Both the NP and the collaborating physician must sign.
How often must the agreement be reviewed or renewed in Pennsylvania?
At least once every two years, or whenever the agreement changes.
Is a backup physician required in Pennsylvania?
Yes, for prescriptive authority collaborations. The prescriptive authority collaborative agreement must name at least one substitute physician who will provide collaboration when the collaborating physician is unavailable.
Board Filing Requirements
Pennsylvania requires the collaborative agreement to be filed with the state, though for prescribing NPs this happens through the online prescriptive authority application. A copy of the prescriptive authority collaborative agreement must be filed with the Bureau of Professional and Occupational Affairs, and the online application itself generates the agreement. An NP cannot begin practicing the moment they apply, because a separate prescriptive authority approval is issued for each collaboration. When an agreement is updated or terminated, the NP must notify the Board in writing.
Source: 49 Pa. Code 21.285(a)(5)
Do you have to file the collaborative agreement with the board in Pennsylvania?
Yes. A copy of the prescriptive authority collaborative agreement must be filed with the Bureau of Professional and Occupational Affairs, and completing the online prescriptive authority application generates the agreement.
Can an NP start practicing as soon as they file in Pennsylvania?
No. A separate approval is granted for each prescriptive authority application, so the NP must wait for that approval before prescribing under a new collaboration.
What are the termination and notice requirements in Pennsylvania?
The NP must notify the Board in writing whenever a prescriptive authority collaborative agreement is updated or terminated, and file the “Change of Prescriptive Authority Collaborative Agreement” form where required. Pennsylvania sets no specified leeway period for unanticipated terminations.
Collaboration Compliance
Pennsylvania’s ongoing obligations center on regular physician availability and review rather than fixed meeting or chart quotas. The physician must be available on a regularly scheduled basis for referrals and review of care, and must be immediately available by telecommunication when the NP is practicing. Chart review is required as part of this regular review, but Pennsylvania does not set a specific number of charts. The NP must keep a copy of any termination form submitted to the Board.
Source: 49 Pa. Code 21.251; 63 Pa. Stat. 212(13)
How many charts must a collaborating physician review in Pennsylvania?
Chart review is required, but no specific number is set. It is part of the physician’s regularly scheduled review of the NP’s care.
How often must an NP and collaborating physician meet in Pennsylvania?
There is no explicit meeting cadence. Pennsylvania requires only that the physician be available on a regularly scheduled basis for referrals and review of services.
How long must collaboration records be kept in Pennsylvania?
Pennsylvania sets no specific retention period, but the NP must keep a copy of any Change of Prescriptive Authority Collaborative Agreement form submitted to the Board of Nursing.
Prescribing Rules
Pennsylvania NPs may prescribe once they obtain prescriptive authority approval, including controlled substances, subject to schedule-specific supply limits. An NP must apply to the Board for prescriptive authority approval, and a CRNP who prescribes or dispenses controlled substances must register with the federal Drug Enforcement Administration (DEA). The categories of drugs the NP may prescribe are set in the collaborative agreement, and prescribing is not independent of the collaboration.
Source: 49 Pa. Code 21.283(b)(2); 49 Pa. Code 21.284(d)
Can an NP prescribe controlled substances in Pennsylvania?
Yes. An NP with prescriptive authority may prescribe controlled substances and must register with the federal DEA to do so.
Can an NP prescribe Schedule II drugs in Pennsylvania?
Yes, with limits. A Pennsylvania NP may write a prescription for a Schedule II controlled substance for up to a 30-day supply, as identified in the collaborative agreement.
What schedule drugs can an NP prescribe in Pennsylvania?
An NP may prescribe from the categories of drugs identified in the collaborative agreement. Controlled-substance supply is capped: Schedule II up to a 30-day supply, and Schedules III–IV up to a 90-day supply.
Does an NP need a DEA license in Pennsylvania?
Yes, to prescribe controlled substances. A CRNP authorized to prescribe or dispense controlled substances must register with the federal DEA. The master data refers to DEA registration generally and does not specify a separate Pennsylvania state controlled-substance registration.
Can an NP prescribe independently (without physician sign-off) in Pennsylvania?
No. An NP prescribes only in collaboration with a physician, within the drug categories identified in the collaborative agreement.
Specialty & Telehealth Requirements
Pennsylvania sets no specialty-specific collaboration requirements and no telehealth-specific requirements. The NP’s certified specialty must be identified in the collaborative agreement, but no additional specialty rules apply. Pennsylvania is silent on telehealth-specific collaboration requirements.
Source: 49 Pa. Code 21.251
Are there telehealth or telemedicine requirements for NPs in Pennsylvania?
No. Pennsylvania sets no telehealth-specific collaboration requirements.
Are there specialty-specific requirements for NPs in Pennsylvania?
No. Pennsylvania sets no specialty-specific requirements, though the NP’s certified specialty must be identified in the collaborative agreement.
How do you verify a collaborating physician’s license in Pennsylvania?
You can verify a physician’s license through the Pennsylvania Department of State’s online license verification, which covers professionals licensed by the state’s professional boards.
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