PMHNP · Texas
Supervision Agreement for Psychiatric Mental Health Nurse Practitioners in Texas
Yes, a written supervising-physician agreement is required. Texas does not name a specific instrument.
PMHNP is simply the 'psych/mental health' population focus of the Certified Nurse Practitioner role (22 Tex. Admin. Code § 221.2) — Texas's Board of Nursing and Medical Board rules draw no administrative distinction from general NPs; see the `np` entry. The only PMHNP-specific boundary is clinical scope (Board Position Statement 15.12), not a different supervision regime.
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
No proximity requirement
Identical standard to general NPs — no codified mileage/radius or continuous-availability rule.
Supervision ratio
Up to 7 at a time (combined across provider types)
Same combined APRN+PA cap as `np` (§ 157.0512(c)) — Texas statute does not give PMHNPs a separate, higher ratio the way some states do.
Chart review
Not codified — left to the agreement
Meeting cadence
Monthly, in person or via telehealth
Identical cadence and no-fixed-percentage chart-review rule as `np` (§ 157.0512(e)(9)).
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Same statutory scope as general NPs (§ 157.0511) — no PMHNP-specific schedule restriction found. PMHNP prescribing in practice skews toward Schedule II stimulants and Schedule IV benzodiazepines more heavily than general primary-care NP practice — not a different legal limit, but a different real-world risk/complexity profile (reflected in calculatorWeights below, not in this rule itself).
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same as the general `np` entry — PMHNPs are an NP population focus, not a separately licensed role, so § 301.012's omission of APRNs applies identically. No statutory ownership pathway into a medical PA/PLLC.
Legal sources for these rules (4)
- 22 Tex. Admin. Code § 221.2 — Advanced Practice Registered Nurse (population foci)
- Tex. Occ. Code §§ 157.0511, 157.0512
- Texas Board of Nursing — APRN Scope of Practice Decision-Making Model
- Texas BON Position Statement 15.12 — Use of American Psychiatric Association Diagnoses by LVNs, RNs, or APRNs (corrected from a prior mis-citation of 15.28, which is actually 'The Registered Nurse Scope of Practice' and unrelated to PMHNP)
What a supervising physician costs here
Typical monthly cost in Texas
$500 – $800
Estimate for one Psychiatric Mental Health Nurse Practitioner. This state's rules add a restrictive-tier premium.
About Texas's rules
Texas has no independent-practice pathway for any APRN type (NP/PMHNP/CRNA/CNM/CNS) at any experience level — a 2025 rural 10-year/20,000-hour bill (S.B. 3055) died in committee, as did 2023's full-practice-authority S.B. 1700. No chart-review percentage is codified (the physician and provider set the number themselves) — the commonly-cited 10%/20% figures reflect a pre-2013 rule since repealed. PA is the only non-physician profession with a statutory joint-ownership pathway into a medical entity.
Other clinicians in Texas: see the state overview.