NP · District of Columbia
Supervision Agreement for Nurse Practitioners in District of Columbia
No. Nurse Practitioners practice independently here. District of Columbia does not require one.
HORA 2024 repealed D.C. Code § 3-1206.03's collaboration mandate — an NP may diagnose, treat, and prescribe under their own license with no supervising- or collaborating-physician relationship required, regardless of experience.
What the supervision must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
No proximity requirement
No physician availability/proximity standard applies — HORA 2024 removed the collaboration requirement entirely (D.C. Code Title 3, Ch. 12, Subch. VI).
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Requires DEA registration and a separate DC controlled-substance registration. Some secondary sources state NPs may not issue refillable prescriptions for controlled substances — this specific no-refill limit could not be confirmed against primary DC regulation text in this pass; flag for verification before relying on it.
Written agreement
Not required
Unconditional as of HORA 2024 (2024) — a physician relationship may still be privately negotiated (e.g. a referral arrangement or medical-director role), but DC law no longer requires one as a condition of NP practice.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — NPs practice under the Board of Nursing rather than the Board of Medicine's § 29-508 physician-only PC/PLLC regime, but no DC statute enumerating an independent NP practice-entity ownership pathway was confirmed in this pass — treat as an open item rather than a settled fact.
Distinct from the clinical independence granted by HORA 2024 above — entity ownership and clinical practice authority are separate legal questions.
Legal sources for these rules (3)
- D.C. Code § 3-1206.03 [Repealed by the Health Occupations Revision Amendment Act of 2024 (D.C. Law 25-191 / B25-0545)]
- D.C. Code § 3-1206.07a — Certified Nurse Practitioner scope of practice
- D.C. Code § 3-1201.02 — Definitions of health occupations
What a supervising physician costs here
Typical monthly cost in District of Columbia
$500 – $600
Estimate for one Nurse Practitioner. Standard-tier state.
About District of Columbia's rules
The Health Occupations Revision Amendment Act of 2024 repealed D.C. Code § 3-1206.03, eliminating the collaboration mandate for all APRN categories (NP/PMHNP/CRNA/CNM/CNS) — DC is now a full-practice-authority jurisdiction for APRNs. PAs are NOT covered by that reform and still require a Board of Medicine Delegation Agreement regardless of experience; no autonomous-PA pathway was found in DC as of this pass.
Other clinicians in District of Columbia: see the state overview.