NP · Massachusetts
Supervision Agreement for Nurse Practitioners in Massachusetts
Yes, a written supervising-physician agreement is required. Massachusetts calls it a Written Collaborative Arrangement.
Full practice authority (Acts 2020 c.260 §36) lets NPs practice independently after 2 years of supervised practice under mutually-agreed guidelines (or 3 years' independent-practice authority from another state) and Board attestation — not automatic (244 CMR 4.06–4.07). Some secondary sources cite '2,000 hours'; the regulation itself states years, not hours — treat the hours figure as unconfirmed.
Independent practice requires: 2 years of supervised practice under mutually-agreed guidelines with a Qualified Healthcare Professional (244 CMR 4.07), OR ≥3 years of independent-practice authority already held in another state/territory; submission of a Board attestation — independence is not automatic upon hitting the threshold.
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
before the 2-/3-year independent-practice threshold is reached: Available remotely (no on-site requirement)
244 CMR 4.06/4.07 require only 'mutually agreed upon guidelines' with a Qualified Healthcare Professional addressing scope and consultation triggers — no on-site or mile/minute standard is codified.
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
before the 2-/3-year independent-practice threshold is reached: Separate prescribing terms required · controlled substances permitted
Schedule II–V per M.G.L. c. 94C §7; requires MA Controlled Substance Registration and/or DEA registration and MassPAT compliance for opioids.
after the 2-/3-year threshold and Board attestation: Covered by the practice agreement · controlled substances permitted
Prescribes independently with no supervising-physician review; same registration requirements apply.
Written agreement
Required
True for the default pre-independence case (mutually-agreed practice guidelines with a Qualified Healthcare Professional). Once the 2-/3-year threshold is met and the Board attestation is filed, no supervisory or collaborative agreement of any kind is required — full independent practice, including prescribing.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Corporation under M.G.L. c. 156A. Whether nurse-owned PCs/PLLCs are an available pathway for NP-delivered care in MA (as they are in NC/VA) was not confirmed from primary statutory text in this research pass — treat as an open item, not a settled fact.
Ownership eligibility is a separate legal question from independent clinical practice status above — reaching independent-practice authority under 244 CMR 4.07 does not itself resolve the c. 156A ownership question.
Legal sources for these rules (4)
- Acts of 2020, c. 260, §36 — An Act Promoting a Resilient Health Care System That Puts Patients First
- 244 CMR 4.06 — Advanced Practice Registered Nursing, Scope of Practicesecondary
- 244 CMR 4.07 — Advanced Practice Registered Nursing, Prescriptive Practicesecondary
- Massachusetts Board of Registration in Medicine — NP and PA Licensing Guidesecondary
What a supervising physician costs here
Typical monthly cost in Massachusetts
$500 – $600
Estimate for one Nurse Practitioner. This state's proximity rules add a small premium.
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.