Practice Agreement · RN
Registered Nurse Practice Agreement in Massachusetts
Massachusetts law does not require a Registered Nurse 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.
General RN licensure in MA carries no physician-supervision or collaborative-agreement requirement — RNs practice independently within their scope under M.G.L. c.112 §§74-81C and 244 CMR, distinct from the APRN categories above.
What a Registered Nurse practice agreement covers in Massachusetts
Governed by the Massachusetts Board of Registration in Nursing. Each numbered item is a statutory requirement the agreement must satisfy.
The Registered Nurse ("RN") shall practice under the orders, standing orders, or delegation of the Physician. Unlike the collaborative arrangement that applies to Nurse Practitioners during their transition-to-practice period, Massachusetts law does not require a written agreement for this Registered Nurse's general scope of practice; the Physician shall instead be available to the Registered Nurse for consultation regarding clinical and patient care issues arising under any order or delegation.
- The agreement on file also carries 2 scope, 2 education, 2 registration clauses, generated in the document itself.
Statutes and rules cited
- 247 CMR 16.00regulation
Massachusetts Board of Registration in Pharmacy regulation on collaborative drug therapy management, implementing M.G.L. c. 112, §§ 24B1/2–24B3/4.
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
Not codified — left to the agreement
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 · no controlled-substance authority
RNs do not have independent prescriptive authority in MA; they may administer medications only as prescribed by a provider authorized by law to prescribe.
Written agreement
Not required
Unconditional — general RN licensure is never subject to physician supervision or a collaborative-practice agreement in Massachusetts, unlike the APRN/PA categories above.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Corporation under M.G.L. c. 156A for nursing services rendered through an entity — as with the APRN entries above, RN-specific PC/PLLC eligibility was not confirmed from primary text this pass. Non-clinical businesses an RN might own (staffing agency, general wellness business) fall outside that regime entirely and carry no ownership restriction.
For medical-aesthetics (med-spa) businesses performing delegated medical procedures, RN ownership of the business entity would not itself satisfy MA's strict CPOM regime for the clinical entity — this follows the same pattern as every other state on file, but the MA-specific delegation rule was not independently confirmed this pass.
Legal sources for these rules (2)
- M.G.L. c. 112, §§74–81C — Nurse Practice Act
- 244 CMR — Board of Registration in Nursing regulations (general nursing practice)
About Massachusetts's rules
Full practice authority (Acts 2020, c. 260, §36; 244 CMR 4.00) let NPs, PMHNPs, and CNMs practice independently in MA — CNMs immediately, NPs/PMHNPs after a Board-attested transition (244 CMR 4.07). PAs and CRNAs have no independent-practice pathway. MA's professional-corporation ownership rules (M.G.L. c. 156A) are notably strict; this file could not independently re-verify APRN/PA-specific PLLC eligibility this pass — treat CPOM entries as open items.
Other clinicians in Massachusetts: see the state overview.