Collaborative Practice Agreement · NP
Tennessee Collaborative Practice Agreement (CPA) for Nurse Practitioners
Required. The Collaborative Practice Agreement (CPA) is the written instrument Tennessee 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.
TN is a restricted-practice state — NPs must hold a Certificate of Fitness from the Board of Nursing and maintain a written Collaborative Management Agreement (CMA) with a physician for as long as they practice. No experience-based independence pathway was found (TCA § 63-7-123).
What a Tennessee Collaborative Practice Agreement (CPA) must contain
Governed by the Tennessee Board of Nursing and the Tennessee Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Nurse Practitioner shall practice pursuant to a written Collaborative Practice Agreement ("CPA") with the Physician, as required by Tenn. Code Ann. §§ 63-7-123 and 63-7-126. The CPA shall specify the Nurse Practitioner's delegated prescriptive authority by drug category, including any controlled-substance restrictions, and the Physician's availability for consultation. Tennessee law does not fix a numerical limit on the number of Nurse Practitioners with whom a physician may enter into a CPA; the number is left to the Physician's judgment consistent with good medical practice standards.
The Physician shall personally review at least twenty percent (20%) of the Nurse Practitioner's patient charts every thirty (30) days. The Physician shall visit each remote practice location monthly, except that up to ten (10) of the required annual remote-site visits may be conducted by HIPAA-compliant telehealth in lieu of an in-person visit. The CPA shall be reviewed and updated at least every two (2) years.
- The Collaborative Practice Agreement (CPA) on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- Tenn. Comp. R. & Regs. 1140-03-.17 (Collaborative Pharmacy Practice)board rule
Tennessee Board of Pharmacy rule implementing Tenn. Code Ann. § 63-10-217, governing collaborative pharmacy practice agreements: required elements, filing, quality assessment, review and renewal.
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
On-site presence required
The collaborating physician must make an in-person visit to a remote NP practice site 'once every thirty (30) days'; up to 10 of the required annual visits may occur via HIPAA-compliant electronic means, but the rest must be in person.
Supervision ratio
Not codified — no cap on file
Chart review
20% of charts · Monthly (every 30 days) · countersignature required
The collaborating physician must personally (non-delegable) review at least 20% of the NP's charts every 30 days, with documented findings and feedback, PLUS 100% of controlled-substance charts. Additional review is required within 10 business days when medically indicated, on patient request, for prescriptions outside the formulary/protocol, for controlled-drug prescriptions, or for a temporary-certificate holder.
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Prescriptions must be on preprinted pads displaying both the NP's and the collaborating physician's names.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Corporation or PLLC — TN's 'single profession per PC' rule means an NP-owned nursing-services PC is a separate entity from a physician-owned medical PC; see the `pa` entry's CPOM note for the general framework.
Legal sources for these rules (3)
- Tenn. Code Ann. § 63-7-123 — Advanced Practice Nurse Certificate of Fitness; Collaborative Practice
- Tenn. Comp. R. & Regs. Ch. 1000-04 — Advanced Practice Registered Nurses (recodified from the former Ch. 0880-06 joint Board of Nursing/Board of Medical Examiners rule; confirm current chapter number before citing)secondary
- NP Collaborator — Tennessee collaborating-physician requirements (secondary source; cross-checked against a second independent secondary source for the 20%/100%/30-day figures)secondary
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.