NP Full Practice Authority Guide 2026

Last Updated: July 2026

State-by-state practice authority classifications for nurse practitioners

Full Practice states (+ DC)

Reduced Practice

Restricted Practice

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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.

27 states + DC

Reduced Practice

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

12 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 NPs to have a collaborative agreement with a physician. The collaborating physician does not need to be on-site.	View →
Alaska	Full Practice Authority	NPs in Alaska can practice independently, including prescribing controlled substances, without physician oversight.	View →
Arizona	Full Practice Authority	Arizona grants full practice authority to NPs after completing a transition-to-practice period.	View →
Arkansas	Reduced Practice	Arkansas NPs must have a collaborative practice agreement with a physician.	View →
California	Restricted Practice	California requires physician supervision for NPs. Recent legislation (AB 890) is phasing in expanded practice authority through 2026.	View →
Colorado	Full Practice Authority	Colorado NPs can practice independently and prescribe all medications including controlled substances.	View →
Connecticut	Full Practice Authority	Connecticut allows independent NP practice with full prescriptive authority.	View →
Delaware	Full Practice Authority	Delaware NPs have independent practice authority after meeting experience requirements.	View →
District of Columbia	Full Practice Authority	Washington D.C. grants full practice authority to NPs.	View →
Florida	Restricted Practice	Florida requires physician supervision for NP practice under a supervisory protocol; a 2020 law lets NPs with 3,000+ supervised hours in the past five years register for autonomous primary-care practice — family medicine, general pediatrics and general internal medicine only.	View →
Georgia	Restricted Practice	Georgia requires NPs to practice under physician supervision with a protocol agreement.	View →
Hawaii	Full Practice Authority	Hawaii NPs can practice independently with full prescriptive authority.	View →
Idaho	Full Practice Authority	Idaho grants full practice authority to NPs.	View →
Illinois	Reduced Practice	Illinois requires a written collaborative agreement for NPs.	View →
Indiana	Reduced Practice	Indiana NPs must practice under a collaborative agreement with a physician.	View →
Iowa	Full Practice Authority	Iowa NPs have independent practice and prescriptive authority.	View →
Kansas	Full Practice Authority	Kansas NPs have full independent practice authority.	View →
Kentucky	Reduced Practice	Kentucky requires a collaborative agreement for NP practice.	View →
Louisiana	Reduced Practice	Louisiana NPs must have a collaborative practice agreement.	View →
Maine	Full Practice Authority	Maine allows independent NP practice with full prescriptive authority.	View →
Maryland	Full Practice Authority	Maryland grants full practice authority to NPs.	View →
Massachusetts	Full Practice Authority	Massachusetts grants full practice authority to NPs after at least two years of supervised practice; the supervision requirement applies only during that transition period.	View →
Michigan	Restricted Practice	Michigan requires a supervisory agreement between NPs and physicians.	View →
Minnesota	Full Practice Authority	Minnesota NPs can practice independently without physician oversight.	View →
Mississippi	Reduced Practice	Mississippi requires NPs to have a collaborative practice agreement.	View →
Missouri	Restricted Practice	Missouri requires NPs to have a collaborative practice arrangement with physician supervision.	View →
Montana	Full Practice Authority	Montana grants full practice authority to NPs.	View →
Nebraska	Full Practice Authority	Nebraska NPs have full practice authority after a transition period.	View →
Nevada	Full Practice Authority	Nevada grants full practice authority to NPs after 2 years of supervised practice.	View →
New Hampshire	Full Practice Authority	New Hampshire NPs can practice independently.	View →
New Jersey	Reduced Practice	New Jersey NPs need a collaborative agreement with a physician.	View →
New Mexico	Full Practice Authority	New Mexico grants full practice authority to NPs.	View →
New York	Full Practice Authority	New York grants full practice authority to NPs who have completed 3,600 hours of qualifying practice; below that threshold a written collaborative relationship with a physician still applies.	View →
North Carolina	Restricted Practice	North Carolina requires NPs to practice under physician supervision.	View →
North Dakota	Full Practice Authority	North Dakota NPs have independent practice authority.	View →
Ohio	Reduced Practice	Ohio NPs must have a standard care arrangement with a collaborating physician.	View →
Oklahoma	Restricted Practice	Oklahoma requires physician supervision for NPs.	View →
Oregon	Full Practice Authority	Oregon grants full practice authority to NPs.	View →
Pennsylvania	Reduced Practice	Pennsylvania requires a collaborative agreement for NP practice.	View →
Rhode Island	Full Practice Authority	Rhode Island NPs can practice independently.	View →
South Carolina	Restricted Practice	South Carolina requires NPs to practice under physician supervision with written protocols.	View →
South Dakota	Full Practice Authority	South Dakota grants full practice authority to NPs.	View →
Tennessee	Restricted Practice	Tennessee requires physician supervision for NPs.	View →
Texas	Restricted Practice	Texas requires NPs to have a prescriptive authority agreement with a supervising physician.	View →
Utah	Full Practice Authority	Utah grants full practice authority to NPs after completing a mentorship period.	View →
Vermont	Full Practice Authority	Vermont NPs have independent practice authority.	View →
Virginia	Restricted Practice	Virginia requires a practice agreement with a supervising physician for NPs.	View →
Washington	Full Practice Authority	Washington grants full practice authority to NPs.	View →
West Virginia	Reduced Practice	West Virginia NPs must have a collaborative agreement with a physician.	View →
Wisconsin	Reduced Practice	Wisconsin requires NPs to have a collaborative relationship with a physician.	View →
Wyoming	Full Practice Authority	Wyoming NPs can practice independently.	View →

What Practice Authority Changes About Your Earning Options

Practice authority is a legal classification, not a pay scale. It does not set your salary — it sets which ways of earning are open to you in that state. The national median annual wage for nurse practitioners is $129,210 (BLS OEWS, Nurse Practitioners (29-1171) — median annual wage, May 2024); what changes state to state is the structure around that number:

Whether you can own the practice. In a full-practice state you can open and bill under your own practice without a physician agreement. In reduced and restricted states you need a collaborating or supervising physician in place first, which is a real barrier to independent ownership.
Whether a collaboration fee comes out of your revenue. Where an agreement is required, the collaborating physician is typically compensated for it — an ongoing cost against your income that a full-practice colleague does not carry. Fees are negotiated privately and vary widely, so treat any quoted figure with suspicion.
How easily you can take contract and telehealth work. Independent 1099 and telehealth arrangements are simplest where no supervisory relationship has to be arranged and maintained in each state you cover.
Transition-to-practice periods still apply in several full-practice states. Check the Details column in the table above before assuming day-one autonomy.

For actual pay rather than classification, the NP salary guide computes state-level averages from live postings. If independent practice is the goal, the private practice startup guide covers entity formation, credentialing, and a revenue model, and the 1099 vs W2 guide shows what a contract has to pay to beat a salaried package.

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
The Nurse Licensure Compact can remove the RN endorsement step in member states, but not the APRN application. Membership and implementation dates change, so confirm each state against the NCSBN compact map rather than a count published on a jobs board

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?

27 states plus Washington D.C. grant Full Practice Authority to NPs (AANP State Practice Environment, 2025). 12 states have Reduced Practice, requiring a collaborative agreement with a physician, and 11 states have Restricted Practice, requiring physician supervision. Classifications change as state legislatures act, so confirm against the AANP State Practice Environment map before relying on one.

Does Full Practice Authority affect NP pay?

It changes what you are able to do, which in turn shapes what you can be paid for — but this board does not publish a national premium figure, because no verifiable one exists in our data. What practice authority concretely controls: whether you can open and bill under your own practice without a physician agreement, whether you can take independent contract or telehealth work in that state without arranging supervision, and whether a collaborating physician's fee comes out of your revenue. Pay itself varies far more by setting, specialty, experience, and local market than by classification alone. For real numbers, use the state pages in our salary guide, which compute averages from live postings in that state.

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 lets a registered nurse hold one multistate RN license that is recognized across member states. It covers the RN license underpinning your credential, not the APRN license itself — NPs still apply for APRN licensure state by state — but it removes the RN endorsement step, which is often the slowest part of adding a state. Most states have joined and Washington D.C. has not, but membership moves as legislatures act and several jurisdictions sit between enactment and implementation, so we do not publish a count here: check the current roster on the NCSBN compact map at https://www.nursecompact.com/ for each state you plan to cover, and plan extra lead time wherever the compact does not reach.

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NP Full Practice Authority Guide 2026

What is Full Practice Authority (FPA)?

Full Practice Authority

Reduced Practice

Restricted Practice

All 50 States + DC: Practice Authority Classification

What Practice Authority Changes About Your Earning Options

Cross-State Telehealth & Prescriptive Authority

Frequently Asked Questions

What is Full Practice Authority for NPs?

How many states have Full Practice Authority for nurse practitioners?

Does Full Practice Authority affect NP pay?

Can NPs prescribe controlled substances in all states?

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

1099 vs W2 guide

Private practice startup guide

NP salary guide

Find NP Jobs in Your State