NP · Iowa
Supervision Agreement for Nurse Practitioners in Iowa
No. Nurse Practitioners practice independently here. Iowa does not require one.
Iowa ARNPs (the state's term for APRNs, including NP) may practice independently with no collaborative-agreement requirement from the Board of Nursing (Iowa Admin. Code 655—7.4); a collaborative agreement is optional, not mandatory.
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 supervising/collaborating physician relationship is required at all for clinical practice or prescribing (Iowa Admin. Code 655—7.4).
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
ARNPs may independently prescribe drugs, devices, and medical gases, including controlled substances once registered with the DEA and Iowa Board of Pharmacy — no agreement-based restriction.
Written agreement
Not required
Unconditional — Iowa NPs never need a physician agreement to practice their full scope, including independent prescribing.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation under Iowa Code Ch. 496C, or PLLC, owned by nursing licensees — Iowa's 'lawful combination' statute does not include NPs with physicians the way it does physicians with PAs; co-ownership with a physician is generally not available to an NP under this provision.
Ownership is legally distinct from clinical practice authority — the FULL independent-practice status above doesn't change this entity-ownership analysis.
Legal sources for these rules (2)
What a supervising physician costs here
Typical monthly cost in Iowa
$500 – $600
Estimate for one Nurse Practitioner. Standard-tier state.
About Iowa's rules
Iowa APRNs (NP/CRNA/CNM/CNS) may practice, diagnose, and independently prescribe (including controlled substances, with DEA/Board of Pharmacy registration) with no collaborative agreement required by the Board of Nursing — a voluntary agreement is permitted but optional. PAs remain supervised_only under a 5-PA-per-physician cap (Iowa Code Ch. 148C).
Other clinicians in Iowa: see the state overview.