Collaborative Practice Agreement · NP
Pennsylvania Collaborative Agreement for Nurse Practitioners
Required. The Collaborative Agreement is the written instrument Pennsylvania law names for a Nurse Practitioner working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
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 a Pennsylvania Collaborative Agreement must contain
Governed by the Pennsylvania State Board of Nursing and the Pennsylvania State Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Nurse Practitioner ("CRNP") shall practice pursuant to a written Collaborative Agreement with the Physician, and, to the extent the Nurse Practitioner prescribes, a separate written Prescriptive Authority Collaborative Agreement, as required by 49 Pa. Code §§ 21.251–21.288. Each agreement shall name the Nurse Practitioner, the Physician, and at least one substitute collaborating physician, and shall be signed and dated by the Nurse Practitioner and the Physician.
Each agreement shall be reviewed and updated at least every two (2) years, or upon any change in its terms. The Physician shall be available to the Nurse Practitioner on a regularly scheduled basis for referral, consultation, chart review, and co-signature of records as the Parties' agreement requires. Pennsylvania law does not fix a numerical limit on the number of Nurse Practitioners with whom a physician may enter into a Collaborative Agreement.
- The Collaborative Agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- 63 P.S. § 390-9.3statute
Pharmacy Act provision authorizing a pharmacist to enter into a collaborative agreement with a physician to manage drug therapy in a non-institutional setting.
- 49 Pa. Code § 27.302regulation
Required contents and administration of a pharmacist collaborative agreement for management of drug therapy.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
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
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.