CNM · Nebraska
Supervision Agreement for Certified Nurse-Midwives in Nebraska
Yes, a written supervising-physician agreement is required. Nebraska does not name a specific instrument.
Nebraska is described by secondary sources as the only state granting NPs and CRNAs full practice authority while continuing to require a supervising physician for CNMs — the LB 107 (2015) APRN reform did not extend to midwifery. A CNM may practice only in a hospital or birthing center under a board-approved integrated practice agreement (Certified Nurse Midwifery Practice Act).
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)
Statute defines supervision as 'the ready availability of a collaborating licensed practitioner for consultation and direction' — no on-site or mile/minute radius 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
Covered by the practice agreement · controlled substances permitted
Prescriptive scope is defined within the board-approved practice agreement (Certified Nurse Midwifery Practice Act); controlled-substance schedule limits were not separately confirmed in this research pass.
Written agreement
Required
Unconditional — no independence pathway exists; the practice agreement must be board-reviewed and approved and kept on file as a condition of lawful practice.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same Professional LLC framework (Neb. Rev. Stat. § 21-190) as other APRNs above — not independently confirmed as applied specifically to CNM-owned entities.
Legal sources for these rules (4)
- Nebraska Certified Nurse Midwifery Practice Act (Neb. Rev. Stat. Ch. 38, art. 6)
- Neb. Rev. Stat. § 38-611 — Practice Agreement; Standards
- Neb. Rev. Stat. § 38-613 — Permitted Practice Described in Practice Agreement; Supervision; Settings; Board Review
- Unicameral Update — Bill to broaden practice authority for certified nurse-midwives advanced (legislative tracking on pending reform)
What a supervising physician costs here
Typical monthly cost in Nebraska
$500 – $600
Estimate for one Certified Nurse-Midwife. This state's proximity rules add a small premium.
About Nebraska's rules
LB 107 (2015) replaced ongoing APRN physician collaboration with a one-time 2,000-hour transition-to-practice period for nurse practitioners; whether CRNAs and CNSs follow the identical threshold (vs. a different or no threshold) could not be fully confirmed against primary statute text in this pass — verify before relying on those two entries. CNMs remain the most restricted category, unaffected by that reform.
Other clinicians in Nebraska: see the state overview.