CNS · Michigan
Supervision Agreement for Clinical Nurse Specialists in Michigan
Yes, a written supervising-physician agreement is required. Michigan does not name a specific instrument.
Same Mich. Admin. Code R 338.2411 delegation framework as NP/CNM (excluding CRNA) — no independent-practice pathway was identified for CNSs in this pass.
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
Available remotely (no on-site requirement)
Same standard as general NPs.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Annually
Same annual delegation-review requirement as general NPs (Mich. Admin. Code R 338.2411).
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Same Schedule II-V delegation framework as general NPs (Mich. Admin. Code R 338.2411); requires DEA registration.
Written agreement
Required
Unconditional — same annually-reviewed written delegation/authorization requirement as general NPs/CNMs.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same open item as the general `np` entry.
Legal sources for these rules (1)
What a supervising physician costs here
Typical monthly cost in Michigan
$500 – $600
Estimate for one Clinical Nurse Specialist. This state's proximity rules add a small premium.
About Michigan's rules
Michigan has no independent-practice pathway for NPs, CNMs, CNSs, or PAs — specialty certification alone never grants autonomous practice, and delegated authority is renewable/revocable rather than a one-time threshold. CRNAs may deliver anesthesia care independently within the perioperative period but must still maintain a collaborating physician/dentist/podiatrist relationship. A PA-only PLLC has been prohibited since 2010.
Other clinicians in Michigan: see the state overview.