CNS · Massachusetts
Supervision Agreement for Clinical Nurse Specialists in Massachusetts
No. Clinical Nurse Specialists practice independently here. Massachusetts does not require one.
General CNSs are not among the APRN categories granted prescriptive authority in MA (only the psychiatric specialty, tracked here as 'pmhnp,' qualifies under M.G.L. c.94C §7). Without prescribing, MA's regs impose no supervising-physician requirement on general CNS 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
Not codified — left to the agreement
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 · no controlled-substance authority
244 CMR 4.07 lists CRNA, CNM, CNP, and PNMHCS (psychiatric CNS) as the APRN categories authorized for prescriptive practice under M.G.L. c. 94C §7 — general CNS is not included and has no DEA/DPH controlled-substance registration pathway.
Written agreement
Not required
Unconditional — general (non-psychiatric) CNS scope in MA never includes prescribing, so there is no branch or threshold that would trigger a supervision/agreement requirement, unlike the psychiatric specialty tracked separately as `pmhnp`.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same open item as the general `np` entry — Professional Corporation under M.G.L. c. 156A; nurse-owned PC/PLLC eligibility for CNS-delivered care was not confirmed from primary text this pass.
What a supervising physician costs here
Typical monthly cost in Massachusetts
$500 – $600
Estimate for one Clinical Nurse Specialist. Standard-tier state.
About Massachusetts's rules
Full practice authority (Acts 2020, c. 260, §36; 244 CMR 4.00) let NPs, PMHNPs, and CNMs practice independently in MA — CNMs immediately, NPs/PMHNPs after a Board-attested transition (244 CMR 4.07). PAs and CRNAs have no independent-practice pathway. MA's professional-corporation ownership rules (M.G.L. c. 156A) are notably strict; this file could not independently re-verify APRN/PA-specific PLLC eligibility this pass — treat CPOM entries as open items.
Other clinicians in Massachusetts: see the state overview.