NP · Oklahoma
Supervision Agreement for Nurse Practitioners in Oklahoma
Yes, a written supervising-physician agreement is required. Oklahoma calls it a Supervision, Collaboration, and Referral Plan.
Before H.B. 2298, Oklahoma required physician supervision for NP prescriptive authority indefinitely (a AANP 'restricted practice' state). Non-prescribing NP practice itself did not require supervision even pre-reform; the supervision requirement has always attached specifically to prescribing.
Independent practice requires: ≥6,240 hours of supervised clinical practice, then Board of Nursing approval of independent prescriptive authority (H.B. 2298, eff. Nov. 1, 2025).
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
below the 6,240-hour independent-prescriptive-authority threshold: Available remotely (no on-site requirement)
No geographic/proximity requirement; the supervising physician need not be located in Oklahoma. Must be 'continuously available' for consultation via direct contact, telecommunications, or other electronic means.
after Board approval of independent prescriptive authority: No proximity requirement
No ongoing proximity/availability requirement; prescriptions are marked 'Independent Rx Authority' rather than carrying a supervising physician's name.
Supervision ratio
below the 6,240-hour independent-prescriptive-authority threshold: Up to 6 at a time (combined across provider types)
Same combined 6-PA/NP cap under OAC 435:10-13-2 as the `pa` entry above — see that entry's note on the unresolved post-reform conflict in secondary sources about whether this cap still applies.
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Schedule I and II excluded by statutory exclusionary formulary (63 O.S. § 2-312(C)); Schedule III–V limited to a 30-day supply. Requires 45 contact hours of Category B CE (or 3 credit hours Category A) in pharmacotherapeutics within 3 years initially, then 15 hours (or 1 credit) per 2-year renewal; federal DEA and OBNDD registration required; electronic prescribing (EPCS) is mandatory for all controlled substances.
Written agreement
Required
Required only for prescriptive authority below the 6,240-hour threshold — non-prescribing NP practice does not require a supervision agreement at any experience level, and an NP who clears the threshold and is Board-approved needs no ongoing agreement.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — Same as the general CPOM note above — Oklahoma has no CPOM doctrine; an NP may independently own a clinical entity.
Legal sources for these rules (5)
- Oklahoma House Bill 2298 (2025, eff. Nov. 1, 2025) — APRN independent prescriptive authority pathway
- Okla. Stat. tit. 59, §§ 567.3a, 567.4c, 567.5(E) — Nurse Practitioner Supervision/Independent Prescriptive Authority
- Okla. Admin. Code §§ 435:10-13-2, 485:10-16-5(c)
- Okla. Stat. tit. 63, § 2-312(C) — Exclusionary Formulary
- Zivian Health — Oklahoma Nurse Practitioner Collaboration Laws (secondary source consolidating statute citations)secondary
What a supervising physician costs here
Typical monthly cost in Oklahoma
$500 – $600
Estimate for one Nurse Practitioner. This state's proximity rules add a small premium.
About Oklahoma's rules
HB 2298 (APRNs) and HB 2584 (PAs), both 2025 and effective Nov. 1, 2025, created new hours-based independent-practice pathways in a state with no prior pathway for either. Being this recent, secondary sources conflict on whether a 6-provider physician-ratio cap (OAC 435:10-13-2) still applies post-reform — flagged per-provider below rather than guessed. Oklahoma has no corporate-practice-of-medicine doctrine (Okla. A.G. Op. 77-168).
Other clinicians in Oklahoma: see the state overview.