NP · Pennsylvania
Supervision Agreement for Nurse Practitioners in Pennsylvania
Yes, a written supervising-physician agreement is required. Pennsylvania calls it a Collaborative Agreement.
Pennsylvania is a reduced-practice state for CRNPs. Full-practice-authority bills (e.g. S.B. 25) have been reintroduced every session without passing — there is no experience- or hours-based independent-practice pathway.
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)
The collaborating physician must be immediately available in person or by telecommunication; the collaborative agreement must specify the circumstances and frequency of in-person patient visits, but no statewide mile/minute radius is codified (49 Pa. Code § 21.285).
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
Separate prescribing terms required · controlled substances permitted
Collaborative agreement must be reviewed and updated at least every 2 years, with written notice to the Board of any update or termination — this is an agreement-maintenance cadence, not a recurring in-person meeting requirement, so it isn't encoded under meetingRequirements above.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Restricted Professional Company/LLP or professional corporation structures used for medical practices do not list 'the practice of nursing' as an eligible service, and Board of Medicine rules cast doubt on solo CRNP practice ownership — secondary legal commentary (Stevens & Lee) describes the law as leaving 'enough room' for a CRNP to structure ownership but not expressly permitting it. Treat CRNP independent practice ownership as an open, unconfirmed item rather than a settled pathway.
This ownership uncertainty is legally distinct from, and does not change, the Collaborative Agreement requirement governing clinical practice above.
Legal sources for these rules (4)
- 49 Pa. Code § 21.285 — Prescriptive authority collaborative agreements
- 49 Pa. Code § 21.284b — Prescribing, administering and dispensing controlled substances
- Pennsylvania Coalition of Nurse Practitioners — Scope of Practicesecondary
- Stevens & Lee — Can Pennsylvania CRNPs Own a Medical Practice Solo?secondary
What a supervising physician costs here
Typical monthly cost in Pennsylvania
$500 – $650
Estimate for one Nurse Practitioner. This state's proximity rules add a small premium.
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.