CNS · Montana
Supervision Agreement for Clinical Nurse Specialists in Montana
No. Clinical Nurse Specialists practice independently here. Montana does not require one.
CNSs are APRNs under Montana's Nurse Practice Act and are not subject to a physician-supervision or collaborative-agreement requirement. Uniquely among the state's APRN roles, 'regular' CNSs are reported by the Board of Nursing as ineligible to apply for prescriptive authority at all — a scope limitation, not a supervision requirement.
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
Secondary-sourced (nursinglicensure.org and related CE-provider guidance) reporting is that a 'regular' clinical nurse specialist is not eligible to apply for prescriptive authority in Montana, unlike NP/CRNA/CNM — this project could not locate the specific statute/rule provision itself; verify with the Board of Nursing before relying on this for a compliance decision.
Written agreement
Not required
Unconditional — no collaborative or supervisory agreement is required for CNS practice.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same Professional Corporation framework (Title 35, ch. 4, MCA) as other APRNs above.
Legal sources for these rules (3)
- Mont. Code Ann. § 37-8-409 — Advanced Practice Registered Nursing
- Montana Board of Nursing — Scope of Practice resources
- NursingLicensure.org — Montana APRN license requirements (secondary source on CNS prescriptive-authority ineligibility; not independently verified against primary statute/rule text)secondary
What a supervising physician costs here
Typical monthly cost in Montana
$500 – $600
Estimate for one Clinical Nurse Specialist. Standard-tier state.
About Montana's rules
House Bill 810 (2023) would have imposed a 2-year physician/NP-collaboration requirement on APRNs; it was referred to committee and this research could not confirm it became law — current APRN statute text found shows no such requirement, so NP/CRNA/CNM/CNS are coded as independent, but verify this hasn't changed before relying on it. Montana repealed its corporate-practice-of-medicine statute in 1995; CPOM entries below reflect residual board rule, not a clear statutory line.
Other clinicians in Montana: see the state overview.