NP · Georgia

Supervision Agreement for Nurse Practitioners in Georgia

Yes, a written supervising-physician agreement is required. Georgia calls it a Nurse Protocol Agreement.

Practice authoritySupervision required
Written agreementAgreement required
What Georgia calls itNurse Protocol Agreement
Governing boardGeorgia Board of Nursing and the Georgia State Board of Pharmacy
Agreement familyCollaborative Practice
Research date2026-08-14 · clauses 2026-09-03

No experience- or hours-based independent-practice pathway exists for NPs in Georgia — searched for affirmatively, not merely unfound. Even the narrower 'non-prescriptive' delegation track (§43-34-23) requires a signed physician protocol. The 2023-2024 reform, and H.B. 54 (eff. 5/25/2026, home-health ordering + death-certificate signing), expanded delegable authority but created no route to autonomy.

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

Within 50 miles

O.C.G.A. § 43-34-25: the delegating physician must hold an active Georgia medical license, practice medicine in Georgia, and have a principal place of practice either within Georgia or, if outside, within 50 miles of the location where the protocol is utilized (defined as the patient's physical location at time of service — applies even to telehealth encounters per GCMB guidance). This rule was NOT removed by the 2023-2024 reform, contrary to a common assumption; it is a deficiency that cannot be cured on an incomplete protocol submission.

Supervision ratio

Up to 8 at a time (combined across provider types)

O.C.G.A. § 43-34-25(g)/(g.1)/(g.2), as amended by H.B. 1046 (eff. 7/1/2024): a delegating physician is capped at a flat 'combined equivalent of eight' APRN nurse protocol agreements and PA job descriptions together — for BOTH entering agreements and actively supervising, confirmed directly against GCMB's current guidance — raised from a prior 4-APRN cap, with exceptions for hospitals, colleges/universities, public health departments, county boards of health, free clinics, and birthing centers. A Cornell LII mirror still showing 'enter 8/actively supervise 4' language reflects the pre-2024 (2019-vintage) rule, not a surviving distinction.

Chart review

standard (non-accredited-facility) nurse protocol agreement: 10% of charts · Annually · countersignature required

Ga. Comp. R. & Regs. 360-32-.02: delegating physician must review and sign 100% of records for patients who received a controlled-substance prescription — confirmed QUARTERLY, not a one-time pass at prescription — and 100% of records where an adverse outcome occurred (within 30 days of discovery); 10% of all OTHER patient records, reviewed at least annually (coded here as the general 10%/annual figure — the three distinct review tracks aren't separately representable in this schema's single-percentage/frequency field).

accredited-facility nurse protocol agreement (reduced track): 10% of charts · Quarterly

Facilities meeting accreditation/evidence-based-guideline standards may use a flat 10%-of-all-records review, but must hold and document quarterly clinical collaboration meetings (telephone, in-person, or on-site — modality flexible) in exchange.

Meeting cadence

accredited-facility nurse protocol agreement (reduced chart-review track): Quarterly, in person or via telehealth

See chartReview above — this is the trade-off for the reduced 10% review standard. No universal meeting-frequency requirement was found for the standard (non-accredited) track beyond the annual protocol review/renewal itself.

Prescriptive authority

Covered by the practice agreement · controlled substances permitted

Requires a protocol addendum and a DEA registration change — APRN DEA registrations otherwise only permit Schedule III-V.

Written agreement

Required

Unconditional — Georgia's term is a 'nurse protocol agreement' (O.C.G.A. § 43-34-25), a written document mutually signed by the APRN and a physician, filed with GCMB within 30 days of execution, reviewed/renewed at least annually. A separate, narrower track (§ 43-34-23) permits non-prescriptive delegation without Board filing, but still requires a signed physician protocol — there is no branch of NP practice free of a written physician agreement.

Practice ownership (corporate practice of medicine)

Licensee-only ownership required — Same framework as `pa` — O.C.G.A. § 14-7-5 requires PC shareholders to be licensed in, and actively practicing, the profession the entity is organized to deliver. Confirmed directly: § 14-7-5's eligible-profession list explicitly names 'registered professional nursing' as its own listed profession, separate from medicine — an NP may own an entity organized to deliver nursing-scope services, but not a medicine-practicing PC/PLLC.

Legal sources for these rules (6)
The document: Nurse Protocol Agreement
What a Georgia Nurse Protocol Agreement must contain, who governs it and who signs: read the Nurse Protocol Agreement page on practiceagreement.com.

What a supervising physician costs here

Typical monthly cost in Georgia

$500$800

Estimate for one Nurse Practitioner. This state's rules add a restrictive-tier premium.

About Georgia's rules

Georgia remains one of the more restrictive states in this dataset — no independent-practice pathway exists for NP/PMHNP/CRNA/CNM/CNS, and a 50-mile APRN physician-proximity rule was NOT removed by 2023-2024 reform (a common misconception). That reform raised the ratio cap (4→a combined 8 APRNs+PAs) and added a narrow hydrocodone/oxycodone-only Schedule II exception — APRNs/PAs are otherwise barred from Schedule II. Georgia's primary-source sites were unusually inaccessible this pass; treat citations with extra caution pending follow-up.

Other clinicians in Georgia: see the state overview.