NP · Indiana
Supervision Agreement for Nurse Practitioners in Indiana
Yes, a written supervising-physician agreement is required. Indiana calls it a Written Collaborative Practice Agreement.
Indiana is a reduced-practice state with no independent-practice or transition-to-practice pathway for NPs at any experience level — IC 25-23-1-19.4(c)'s collaboration requirement is career-long. Three recent bills that would have removed it all failed: HB 1116 (dead 4/24/2025), HB 1129 (dead 2/27/2026), and SB 60 (2026), which never left committee before sine die. AANP's tracker (updated 05/2026) still lists Indiana as Reduced Practice.
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 proximity, radius, or reachability standard is codified for APRNs. IC 25-23-1-19.4(c) requires only that the practice agreement 'set[] forth the manner in which' the APRN and the licensed practitioner 'will cooperate, coordinate, and consult with each other' — the parties define availability themselves. Coded NONE for absence of a codified distance rule; this is emphatically NOT independent practice (see `agreementRequired` above).
Supervision ratio
Not codified — no cap on file
Chart review
5% of charts · As needed (documentation of prescribing practices submitted to the collaborating practitioner within 7 days)
848 IAC 5-1-1(a)(7) requires the written practice agreement to describe 'the time and manner' of the licensed practitioner's review of the APRN's prescribing practices, with documentation submitted within seven (7) days and including at least a five percent (5%) random sampling of the charts and medications prescribed. Frequency is coded AS_NEEDED because the rule fixes the SIZE of the sample and the submission deadline but leaves the review cycle to the agreement — this is not a monthly or quarterly mandate. Confirmed current: the rule's history line shows 'Readopted filed 7/31/2024.' This is a prescriptive-authority requirement; a non-prescribing APRN is not subject to it.
Meeting cadence
Every 6 months, in person or via telehealth
No scheduled physician-APRN meeting is codified at all. BIANNUAL is coded for the only fixed recurring cycle located: prescriptive authority expires October 31 of the odd-numbered year following its grant or renewal and renews on a two-year cycle (IC 25-23-1-19.5(c)), and 848 IAC 5-1-3 requires a current signed and dated written collaborative practice agreement at each renewal. Read this as a two-yearly agreement-refresh obligation, not a meeting cadence.
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
No Indiana-specific schedule restriction (e.g. a Texas-style Schedule II hospital/hospice limit) was located for APRNs in this pass. One narrow prohibition is visible only indirectly: every recent full-practice-authority bill (HB 1116, HB 1129, SB 60) proposed to ALLOW an APRN to prescribe a Schedule II controlled substance 'for weight reduction or to control obesity,' which implies that prohibition currently exists — but the underlying section was not located and read in this pass, so it is flagged rather than coded. Verify before relying on it.
Written agreement
Required
Unconditional. IC 25-23-1-19.4(c) requires an APRN to 'operate in collaboration with a licensed practitioner as evidenced by a practice agreement,' or alternatively under privileges granted by a hospital governing board — the agreement requirement attaches to APRN practice generally, not only to prescribing. Note the asymmetry in enforcement: the biennial random audit at IC 25-23-1-19.8(a) reaches only APRNs who hold prescriptive authority under IC 25-23-1-19.5, and only prescribers must file their agreement with the board (848 IAC 5-1-1(a)(7)). A non-prescribing APRN still needs an agreement under § 19.4(c) but has no filing or audit obligation attached to it.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — IC 25-22.5-1-2(a)(22) excludes from the Medical Practice Act a 'health care organization whose members, shareholders, or partners' are licensed as any of a named list that includes 'a registered or licensed practical nurse' and 'a certified nurse midwife.' Since IC 25-23-1-1(b) defines every Indiana APRN role as a registered nurse practicing in a specialty role, this file reads that list as reaching APRN-owned entities — a materially better ownership position than Texas's APRNs have, who are omitted from Tex. Bus. Orgs. Code § 301.012 entirely. FLAGGED AS AN INFERENCE: no Board of Nursing or Medical Licensing Board statement was found confirming the reading. A purely lay (unlicensed) owner is not on the § 2(a)(22) list at all, hence nonLicenseeOwnershipAllowed=False.
This analysis governs entity ownership only. It does not extend to any service outside the APRN's own scope — notably delegated medical-aesthetic procedures, which stay under the delegating physician's control via IC 25-22.5-1-2(a)(20) regardless of who owns the entity (see the `esthetician` entry).
Legal sources for these rules (9)
- IC 25-23-1-19.4 — APRN Collaboration With Licensed Practitioner; Privileges (FindLaw mirror, current as of 1/1/2026; subsection (c) confirmed verbatim in Justia's archived 2014 Indiana Code chapter PDF, which reads 'An advanced practice nurse shall operate in collaboration with a licensed practitioner as evidenced by a practice agreement' — the current text carries the same operative language plus a state-institution-hospital option under IC 12-24-1 and Medicaid subsections added in 2019)secondary
- IC 25-23-1-19.5 — APRN Authority to Prescribe (FindLaw mirror, current as of 1/1/2026)secondary
- IC 25-23-1-1(b) and IC 25-23-1-19.8 — APRN definition (NP/CNM/CNS/CRNA) and the biennial 1%-to-10% random audit of prescribers' practice agreements (Justia archived 2014 Indiana Code chapter PDF, decoded locally)secondary
- 848 IAC 5-1-1 — Initial Authority to Prescribe Legend Drugs, incl. subsection (a)(7) practice-agreement contents (7-day documentation, 5% random chart sampling) and (d) dual Indiana-CSR/DEA registration. Cornell LII Indiana Administrative Code mirror; history line confirms 'Readopted filed 7/31/2024'secondary
- 848 IAC 4-1-3 — 'Advanced practice nurse' defined (Board of Nursing rule; notably contains no 'practice agreement' or 'collaboration' language of its own — the requirement lives in the statute)secondary
- AANP — Indiana state page, classifying Indiana as Reduced Practice (secondary advocacy tracker; state-practice-environment page stamped 'Updated: 05/2026')secondary
- IN HB 1116 (2025), dead 4/24/2025, and IN HB 1129 (2026), dead 2/27/2026 — both would have removed the APRN practice-agreement requirement (BillTrack50, secondary; iga.in.gov's SPA returns no fetchable bill history)secondary
- IN SB 60 (2026) — same subject; last recorded action 1/8/2026, still pending in Senate Health and Provider Services Committee; 2026 session since adjourned sine die (LegiScan, secondary; no formal 'dead' stamp located — failure is inferred from sine die adjournment)secondary
- IC 25-22.5-1-2(a)(22), (c) — health care organization ownership and physician employment (FindLaw mirror, current as of 1/1/2026)secondary
What a supervising physician costs here
Typical monthly cost in Indiana
$500 – $650
Estimate for one Nurse Practitioner. This state's rules add a restrictive-tier premium.
About Indiana's rules
Indiana requires a career-long collaborative practice agreement for every APRN role except CRNAs (IC 25-23-1-19.4(c)); APRN prescribers additionally face a codified 5%-of-charts random-sampling review (848 IAC 5-1-1). CRNAs instead face a stricter rule — physician direction and immediate presence (IC 25-23-1-30). Widely repeated reports that Indiana enacted full practice authority in 2026 are unsupported: HB 1116, HB 1129 and SB 60 all failed. Indiana's corporate-practice doctrine is comparatively permissive.
Other clinicians in Indiana: see the state overview.