CNS · Pennsylvania
Supervision Agreement for Clinical Nurse Specialists in Pennsylvania
Not unconditionally. Pennsylvania does not name a specific instrument.
49 Pa. Code Chapter 21, Subchapter H governs CNS practice but limits it to acts already within the scope of professional nursing — CNS-specific collaborative-agreement/supervision detail beyond that was not confirmed in this research pass; treat this entry as provisional pending direct confirmation from the State Board of Nursing.
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
CNS prescriptive authority in Pennsylvania was not confirmed in this research pass — treat as uncertain rather than a confirmed absence of authority.
Written agreement
Not required
Unconfirmed rather than affirmatively 'no agreement needed' — secondary sources note only 11 states require a CNS collaborative-practice agreement and don't clearly place Pennsylvania in that group, but this wasn't independently verified against Subchapter H's text. Treat as an open item.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same physician/licensee-only ownership regime as the general `pa`/`np` entries — no CNS-specific independent-ownership statute was found in this research pass.
Legal sources for these rules (1)
What a supervising physician costs here
Typical monthly cost in Pennsylvania
$500 – $600
Estimate for one Clinical Nurse Specialist. Standard-tier state.
About Pennsylvania's rules
Pennsylvania has no independent-practice pathway for CRNPs — SB 25-style full-practice-authority bills have been introduced every session without passing. PA (physician assistant) reform via Acts 78/79 of 2021 removed prior Board pre-approval of written agreements and the flat 100%-countersignature rule after the first year, but a written agreement and supervision remain mandatory. PA is a CPOM state: only licensed physicians may own a medical professional corporation.
Other clinicians in Pennsylvania: see the state overview.