CNM · Tennessee
Supervision Agreement for Certified Nurse-Midwives in Tennessee
Yes, a written supervising-physician agreement is required. Tennessee does not name a specific instrument.
TN licenses CNMs as one of its APRN roles under the same general Certificate of Fitness/Collaborative Management Agreement framework as NPs (TCA § 63-7-123). No CNM-specific (obstetric) carve-out or independence pathway was confirmed in this research pass — treated as identical to general NP absent evidence otherwise.
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
On-site presence required
Assumed same standard as general NPs (in-person site visit every 30 days) — not independently confirmed as CNM-specific in this pass.
Supervision ratio
Not codified — no cap on file
Chart review
20% of charts · Monthly (every 30 days) · countersignature required
Assumed same standard as general NPs — not independently confirmed as CNM-specific in this pass.
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Assumed same formulary/CMA-based framework as general NPs; no CNM-specific (obstetric) schedule carve-out was confirmed in this research pass.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same as the general `np` entry.
Legal sources for these rules (1)
- Tenn. Code Ann. § 63-7-123 — Advanced Practice Nurse Certificate of Fitness; Collaborative Practice
What a supervising physician costs here
Typical monthly cost in Tennessee
$500 – $650
Estimate for one Certified Nurse-Midwife. This state's rules add a restrictive-tier premium.
About Tennessee's rules
TN is a restricted-practice state for NPs — no independence pathway exists. Physicians must personally review ≥20% of an APRN's charts every 30 days (100% of controlled-substance charts) and visit remote practice sites in person every 30 days. TN has an explicit, unambiguous corporate-practice-of-medicine ban (statute, case law, and AG opinions; TCA § 63-6-204) — a professional corporation may practice only a single profession.
Other clinicians in Tennessee: see the state overview.