Practice Agreement · NP
New York Written Practice Agreement for Nurse Practitioners
Required. The Written Practice Agreement is the written instrument New York 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.
Independent-practice exemption (§6902) requires ≥3,600 practice hours; below that, a written practice agreement + protocols with a specialty-matched physician is required, plus quarterly chart review and a 4-NP off-site ratio cap. This is a repeatedly-extended SUNSET provision, currently through July 1, 2030 (Ch. 57, Laws of 2026, signed May 28, 2026) — confirmed against the codified statute text, not permanent law.
Independent practice requires: ≥3,600 hours of practice as a certified NP (in NY, another state, or federal/VA/Armed Forces/PHS service); Below that threshold: a written practice agreement AND written practice protocols with a physician qualified in the NP's specialty are required.
What a New York Written Practice Agreement must contain
Governed by the New York State Education Department, State Board for Nursing, and State Board for Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
Unless the Nurse Practitioner qualifies to practice without a written practice agreement under Education Law § 6902 (currently available upon at least 3,600 hours of qualifying practice experience, and scheduled to sunset July 1, 2030 absent further legislative extension), the Nurse Practitioner shall practice pursuant to a written practice agreement and written practice protocols with the Physician, who must be currently registered in New York and qualified in the Nurse Practitioner's specialty area. The practice agreement shall address patient referral and consultation, coverage during either party's absence, and resolution of disagreements over diagnosis or treatment, which absent other agreement shall be resolved in accordance with the Physician's determination.
Source: N.Y. Educ. Law § 6902
The Physician shall review the Nurse Practitioner's patient charts or records in a timely fashion, but no less often than every three (3) months. The practice agreement and protocols shall be kept at each of the Nurse Practitioner's practice sites and made available to the New York State Education Department upon inspection. A newly certified Nurse Practitioner shall file Form 4NP ("Verification of Collaborative Agreement and Practice Protocol") with the Department within ninety (90) days of beginning practice; no further Form 4NP filing is required for additional practice sites covered by the same agreement.
Source: NYSED Office of the Professions -- Practice Requirements for Nurse Practitioners
- The Written Practice Agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- N.Y. Educ. Law § 6902statute
Defines the practice of nursing and the Nurse Practitioner written practice agreement requirement, including the 3,600-hour independent-practice threshold (currently scheduled to sunset July 1, 2030).
- NYSED Office of the Professions -- Practice Requirements for Nurse Practitionersboard guidance
State Education Department guidance summarizing current Nurse Practitioner practice agreement and chart-review requirements.
- N.Y. Educ. Law § 6542statute
Requires continuous physician supervision of a Physician Assistant's performance of medical services.
- N.Y. Educ. Law § 6801-astatute
Collaborative Drug Therapy Management Demonstration Program, limited to qualifying teaching/general hospitals and certain nursing homes.
- 8 NYCRR § 63.10; NYSED Collaborative Drug Therapy Management guidanceboard guidance
State Education Department's official page describing the Collaborative Drug Therapy Management program for pharmacists.
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
NP under written practice agreement (below 3,600 practice hours): No proximity requirement
No codified physical-proximity/radius standard found — the statute's focus is the written agreement/protocol and quarterly chart review, not physical location.
Supervision ratio
NPs not located on the same physical premises as the collaborating physician: Up to 4 at a time
'No physician shall enter into practice agreements with more than four nurse practitioners who are not located on the same physical premises' (Educ. Law §6902) — this caps OFF-SITE collaborative relationships specifically; NPs co-located with the physician on the same premises appear to fall outside this numeric cap entirely.
Chart review
Not codified — left to the agreement
Meeting cadence
NP under written practice agreement (below 3,600 practice hours): Quarterly, in person or via telehealth
The collaborating physician must review patient records 'in a timely fashion but in no event less often than every three months' (Educ. Law §6902; 8 NYCRR §29.1) — this is a chart-review cadence, not a formal in-person meeting mandate; op.nysed.gov guidance explicitly states 'no minimum number of charts for review is mandated,' only the quarterly minimum frequency.
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Schedule II-V, limited to the NP's certified specialty area (Educ. Law §6902(3)(b)), after NYSED-approved pharmacology coursework and a prescriptive-authority certificate, plus DEA registration and NYS Bureau of Narcotics Enforcement 'official prescription' authorization. Subject to the same I-STOP e-prescribing/PMP-consultation mandate as physicians/PAs.
Written agreement
Required
Branches on the 3,600-hour threshold. Below it: a written practice agreement AND written practice protocols are required, with a physician qualified in the NP's specialty — the agreement must specify that the collaborating physician's diagnosis or treatment prevails if the two disagree. At/above the threshold, CONFIRMED (verbatim, read directly from the current codified §6902 text): the NP 'shall not be required to comply' with the written-agreement/protocol requirement at all — a mandatory full exemption, not merely optional. (A different bracketed version of the same subdivision, taking over July 1, 2030, changes the verb to 'may comply... in lieu of' — i.e., the NP gets a choice, but is still never compelled into a physician relationship — so the 'no obligation' answer holds under both the current and forthcoming text.)
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same strict same-profession-ownership regime as `pa` — an NP may own an NP/nursing-scope PC or PLLC (Bus. Corp. Law §§1503/1506/1507 / LLC Law §1207(b) require all shareholders/members to be licensed in the SAME profession as the entity's services), but not a medical (physician-scope) PC/PLLC — confirmed by the parallel LLC Law §1203 rule for medical-services PLLCs (Article 131/Medicine licensees only).
Legal sources for these rules (7)
- N.Y. Educ. Law § 6902 (practice of nursing, NP collaboration/independence framework)
- N.Y. Educ. Law § 6910 (NP certification)
- NYSED Office of the Professions — NP practice requirements
- 8 NYCRR Part 64 — Nursing regulations
- NYSED 'NP-CR' Collaborative Relationships attestation form — exists per NYSED's site structure, but fetch attempts returned only undecodable PDF binary; not independently read. Per the confirmed statutory text, no such attestation is legally required above 3,600 hours regardless of whether NYSED still offers/requests it in practice.
- S2360/A1220 (2025-26 session) — pending bill to make independence permanent, not enacted
- A10007-C/S9007-C (2026 Health and Mental Hygiene budget bill) — Ch. 57, Laws of 2026, signed 5/28/2026, extended the independence sunset to July 1, 2030 (confirmed against the codified §6902 text itself; the bill's own mechanical language wasn't independently readable)
About New York's rules
New York combines an unusually strict general corporate-practice-of-medicine regime (physician/same-profession-only PC/PLLC ownership) with two notable exceptions: pharmacy ownership is NOT restricted to pharmacists (Educ. Law §6808), and midwifery (CNM) is its own fully independent practice act (Art. 140), unlike the physician-collaboration model governing NP/PMHNP. CRNA has no dedicated practice statute at all — governed only by DOH facility regulation. NP/PMHNP independence (≥3,600 hours) is a repeatedly-extended sunset provision (currently through July 1, 2030), not permanent law.
Other clinicians in New York: see the state overview.