NP Full Practice Authority Guide 2026

Last Updated: July 2026

State-by-state practice authority classifications for nurse practitioners

Full Practice Authority

Reduced Practice

Restricted Practice

What is Full Practice Authority (FPA)?

Full Practice Authority allows NPs (nurse practitioners) to evaluate patients, diagnose conditions, order and interpret diagnostic tests, prescribe medications (including controlled substances), and manage treatment plans without physician oversight or a collaborative agreement.

Full Practice Authority

Independent practice. No physician oversight. Full prescriptive authority including Schedule II-V.

26 states + DC

Reduced Practice

Requires a collaborative agreement with a physician. Physician does not need to be on-site.

14 states

Restricted Practice

Requires physician supervision. Must practice under a supervisory protocol or agreement.

11 states

All 50 States + DC: Practice Authority Classification

State	Practice Authority	Details	Jobs
Alabama	Reduced Practice	Alabama requires PMHNPs to have a collaborative agreement with a physician. The collaborating physician does not need to be on-site.	View →
Alaska	Full Practice Authority	PMHNPs in Alaska can practice independently, including prescribing controlled substances, without physician oversight.	View →
Arizona	Full Practice Authority	Arizona grants full practice authority to PMHNPs after completing a transition-to-practice period.	View →
Arkansas	Reduced Practice	Arkansas PMHNPs must have a collaborative practice agreement with a physician.	View →
California	Restricted Practice	California requires physician supervision for PMHNPs. Recent legislation (AB 890) is phasing in expanded practice authority through 2026.	View →
Colorado	Full Practice Authority	Colorado PMHNPs can practice independently and prescribe all medications including controlled substances.	View →
Connecticut	Full Practice Authority	Connecticut allows independent PMHNP practice with full prescriptive authority.	View →
Delaware	Full Practice Authority	Delaware PMHNPs have independent practice authority after meeting experience requirements.	View →
District of Columbia	Full Practice Authority	Washington D.C. grants full practice authority to PMHNPs.	View →
Florida	Restricted Practice	Florida requires physician supervision for PMHNP practice. PMHNPs must work under a supervisory protocol.	View →
Georgia	Restricted Practice	Georgia requires PMHNPs to practice under physician supervision with a protocol agreement.	View →
Hawaii	Full Practice Authority	Hawaii PMHNPs can practice independently with full prescriptive authority.	View →
Idaho	Full Practice Authority	Idaho grants full practice authority to PMHNPs.	View →
Illinois	Reduced Practice	Illinois requires a written collaborative agreement for PMHNPs.	View →
Indiana	Reduced Practice	Indiana PMHNPs must practice under a collaborative agreement with a physician.	View →
Iowa	Full Practice Authority	Iowa PMHNPs have independent practice and prescriptive authority.	View →
Kansas	Full Practice Authority	Kansas PMHNPs have full independent practice authority.	View →
Kentucky	Reduced Practice	Kentucky requires a collaborative agreement for PMHNP practice.	View →
Louisiana	Reduced Practice	Louisiana PMHNPs must have a collaborative practice agreement.	View →
Maine	Full Practice Authority	Maine allows independent PMHNP practice with full prescriptive authority.	View →
Maryland	Full Practice Authority	Maryland grants full practice authority to PMHNPs.	View →
Massachusetts	Reduced Practice	Massachusetts requires PMHNPs to have a supervisory agreement, though requirements vary by practice setting.	View →
Michigan	Restricted Practice	Michigan requires a supervisory agreement between PMHNPs and physicians.	View →
Minnesota	Full Practice Authority	Minnesota PMHNPs can practice independently without physician oversight.	View →
Mississippi	Reduced Practice	Mississippi requires PMHNPs to have a collaborative practice agreement.	View →
Missouri	Restricted Practice	Missouri requires PMHNPs to have a collaborative practice arrangement with physician supervision.	View →
Montana	Full Practice Authority	Montana grants full practice authority to PMHNPs.	View →
Nebraska	Full Practice Authority	Nebraska PMHNPs have full practice authority after a transition period.	View →
Nevada	Full Practice Authority	Nevada grants full practice authority to PMHNPs after 2 years of supervised practice.	View →
New Hampshire	Full Practice Authority	New Hampshire PMHNPs can practice independently.	View →
New Jersey	Reduced Practice	New Jersey PMHNPs need a collaborative agreement with a physician.	View →
New Mexico	Full Practice Authority	New Mexico grants full practice authority to PMHNPs.	View →
New York	Reduced Practice	New York requires a collaborative agreement for PMHNPs, though recent legislation is expanding autonomy.	View →
North Carolina	Restricted Practice	North Carolina requires PMHNPs to practice under physician supervision.	View →
North Dakota	Full Practice Authority	North Dakota PMHNPs have independent practice authority.	View →
Ohio	Reduced Practice	Ohio PMHNPs must have a standard care arrangement with a collaborating physician.	View →
Oklahoma	Restricted Practice	Oklahoma requires physician supervision for PMHNPs.	View →
Oregon	Full Practice Authority	Oregon grants full practice authority to PMHNPs.	View →
Pennsylvania	Reduced Practice	Pennsylvania requires a collaborative agreement for PMHNP practice.	View →
Rhode Island	Full Practice Authority	Rhode Island PMHNPs can practice independently.	View →
South Carolina	Restricted Practice	South Carolina requires PMHNPs to practice under physician supervision with written protocols.	View →
South Dakota	Full Practice Authority	South Dakota grants full practice authority to PMHNPs.	View →
Tennessee	Restricted Practice	Tennessee requires physician supervision for PMHNPs.	View →
Texas	Restricted Practice	Texas requires PMHNPs to have a prescriptive authority agreement with a supervising physician.	View →
Utah	Full Practice Authority	Utah grants full practice authority after completing a mentorship period.	View →
Vermont	Full Practice Authority	Vermont PMHNPs have independent practice authority.	View →
Virginia	Restricted Practice	Virginia requires a practice agreement with a supervising physician for PMHNPs.	View →
Washington	Full Practice Authority	Washington grants full practice authority to PMHNPs.	View →
West Virginia	Reduced Practice	West Virginia PMHNPs must have a collaborative agreement with a physician.	View →
Wisconsin	Reduced Practice	Wisconsin requires PMHNPs to have a collaborative relationship with a physician.	View →
Wyoming	Full Practice Authority	Wyoming PMHNPs can practice independently.	View →

How Practice Authority Impacts NP Salary

Practice authority directly impacts earning potential. NPs in Full Practice Authority states benefit from:

+12-15%

Salary Premium

FPA states pay more due to higher demand and independent practice opportunities

2-3x

More Private Practice Owners

FPA states enable easier private practice startup without physician partnership

See our full 2026 NP Salary Guide for state-by-state salary data and our Private Practice Startup Guide for step-by-step instructions.

Cross-State Telehealth & Prescriptive Authority

For remote and telehealth NPs, practice authority in the patient's state determines your scope — not your home state. Key considerations:

You must hold an APRN license in each state where your patients are located
DEA registration is required in each state where you prescribe controlled substances
Some telehealth companies handle multi-state licensing and credentialing for you
Restricted practice states may require a collaborative physician in that specific state
Pandemic-era telehealth waivers have mostly expired — verify current requirements

Browse remote NP jobs or telehealth positions that handle multi-state licensing.

Frequently Asked Questions

What is Full Practice Authority for NPs?

Full Practice Authority (FPA) means an NP can evaluate patients, diagnose conditions, order and interpret tests, prescribe medications (including controlled substances), and manage treatment plans without physician oversight or a collaborative agreement. FPA states grant NPs the same level of autonomy as physicians in their scope of practice.

How many states have Full Practice Authority for nurse practitioners?

As of 2026, 26 states (plus Washington D.C.) grant Full Practice Authority to NPs. 14 states have Reduced Practice (requiring collaborative agreements), and 11 states have Restricted Practice (requiring physician supervision).

Does Full Practice Authority affect NP salary?

Yes. NPs in Full Practice Authority states earn 12-15% more on average than those in restricted states, due to increased autonomy, private practice opportunities, and higher demand. FPA states also have more job openings per capita.

Can NPs prescribe controlled substances in all states?

NPs can prescribe controlled substances in all 50 states, but the requirements differ. In FPA states, prescribing is independent. In reduced practice states, a collaborative agreement is needed. In restricted states, a supervisory protocol with a physician is required. All NPs need DEA registration.

What is the Nurse Licensure Compact (NLC) and how does it help NPs?

The NLC allows registered nurses to hold one multistate license and practice in all member states. While the NLC covers RN licensure, NPs still need individual state APRN licenses. However, having an NLC RN license simplifies the APRN application process in many compact states. As of 2026, 41 states are NLC members.

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