Practice Agreement · NP

Nurse Practitioner Practice Agreement in District of Columbia

District of Columbia law does not require a Nurse Practitioner to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.

Practice authorityIndependent practice
Written agreementNo agreement required
What District of Columbia calls itNo instrument required
Governing boardDC Board of Nursing and the DC Board of Pharmacy
Research date2026-09-03 · clauses 2026-09-03

HORA 2024 repealed D.C. Code § 3-1206.03's collaboration mandate — an NP may diagnose, treat, and prescribe under their own license with no supervising- or collaborating-physician relationship required, regardless of experience.

What a Nurse Practitioner practice agreement covers in District of Columbia

Governed by the DC Board of Nursing and the DC Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.

  1. The District of Columbia does not require the Nurse Practitioner to enter into a collaborative practice agreement with a physician; the requirement formerly codified at DC Code § 3-1206.03 was repealed by the Health Occupations Revision Amendment Act of 2024. The Nurse Practitioner practices, diagnoses, and prescribes under the Nurse Practitioner's own license, in accordance with DC Code Title 3, Chapter 12, Subchapter VI.

  2. This Agreement's terms regarding the Nurse Practitioner accordingly serve to define the working relationship, referral pathways, and any Medical Director oversight between the Parties, and are not themselves required by District of Columbia law as a condition of the Nurse Practitioner's authority to practice.

  3. The agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.

Statutes and rules cited

  1. DC Code § 3-1202.08statute

    Authorizes pharmacist-physician collaborative practice agreements to initiate, modify, or discontinue a drug therapy regimen, and directs the Board of Pharmacy and Board of Medicine to jointly issue implementing regulations.

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

No proximity requirement

No physician availability/proximity standard applies — HORA 2024 removed the collaboration requirement entirely (D.C. Code Title 3, Ch. 12, Subch. VI).

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

Covered by the practice agreement · controlled substances permitted

Requires DEA registration and a separate DC controlled-substance registration. Some secondary sources state NPs may not issue refillable prescriptions for controlled substances — this specific no-refill limit could not be confirmed against primary DC regulation text in this pass; flag for verification before relying on it.

Written agreement

Not required

Unconditional as of HORA 2024 (2024) — a physician relationship may still be privately negotiated (e.g. a referral arrangement or medical-director role), but DC law no longer requires one as a condition of NP practice.

Practice ownership (corporate practice of medicine)

Licensee-only ownership required — NPs practice under the Board of Nursing rather than the Board of Medicine's § 29-508 physician-only PC/PLLC regime, but no DC statute enumerating an independent NP practice-entity ownership pathway was confirmed in this pass — treat as an open item rather than a settled fact.

Distinct from the clinical independence granted by HORA 2024 above — entity ownership and clinical practice authority are separate legal questions.

Legal sources for these rules (3)
How the relationship works day to day
Who has to be where, how often you meet, and what the physician costs: Nurse Practitioner in District of Columbia on collaborativeagreement.com.

About District of Columbia's rules

The Health Occupations Revision Amendment Act of 2024 repealed D.C. Code § 3-1206.03, eliminating the collaboration mandate for all APRN categories (NP/PMHNP/CRNA/CNM/CNS) — DC is now a full-practice-authority jurisdiction for APRNs. PAs are NOT covered by that reform and still require a Board of Medicine Delegation Agreement regardless of experience; no autonomous-PA pathway was found in DC as of this pass.

Other clinicians in District of Columbia: see the state overview.