Regulations

NP Collaborating Physician Meeting Requirements: 50 State Guide

Chris Turitzin
June 17, 2026
10 mins
Updated:
June 17, 2026

TABLE OF CONTENTS

h2
Example H2

NP and APRN collaborating physician meeting requirements vary by state. Some states require monthly meetings, semiannual quality meetings, annual face-to-face review, remote-site visits, onsite observation, or other recurring touchpoints. Many states do not set a fixed meeting frequency at all.

Use the table below as a state-by-state reference. If a state is listed as "No fixed frequency," that means the state does not set a specific NP-physician meeting schedule in the rules summarized here. The collaboration agreement, protocol, or clinical workflow may still need to define communication, consultation, availability, or quality review.

Key Highlights
  • 41 jurisdictions do not set a fixed NP/APRN-collaborating physician meeting frequency.
  • 5 states have fixed meeting-frequency requirements: Illinois, Kentucky, North Carolina, Texas, and West Virginia.
  • 5 states have fixed frequency plus in-person, onsite, remote-site, direct-observation, or physical-presence components: Alabama, Georgia, Missouri, Nevada, and Tennessee.

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Meeting requirements by state

The table below summarizes each state's NP/APRN collaborating physician meeting rule. It separates fixed meeting schedules, fixed schedules with in-person or site-visit components, mixed requirements, and states with no fixed frequency.

For states listed as no fixed frequency, the collaboration agreement, protocol, or clinical workflow may still need to define communication, consultation, availability, or quality review.

NP/APRN collaborating physician meeting requirements by state
State Category Summary Notes
Alabama Fixed frequency + in-person Remote site visits and physician presence. Lower-experience CRNPs trigger the presence rule; remote sites need twice-yearly visits; quarterly meetings apply after 4,000 hours.1
Alaska No fixed frequency2    
Arizona No fixed frequency3    
Arkansas No fixed frequency   CPA must address physician availability, management, and emergency coverage.4
California No fixed frequency   Standardized Procedures define supervision.5
Colorado No fixed frequency   Prescriptive mentorship must define the frequency of ongoing synchronous communication.6
Connecticut No fixed frequency   Agreement defines consultation, referral, and coverage.7
Delaware No fixed frequency8    
District of Columbia No fixed frequency9    
Florida No fixed frequency   If a supervisory protocol applies, set any cadence there.10
Georgia Fixed frequency + in-person Annual onsite observation required. The physician or designee must be available for consultation.11
Hawaii No fixed frequency12    
Idaho No fixed frequency13    
Illinois Fixed meeting frequency Monthly controlled-substance discussion required. Applies when an APRN prescribes controlled substances under delegation; FPA APRNs have separate Schedule II consultation rules.14
Indiana No fixed frequency   Agreement must address collaboration and proximity.15
Iowa No fixed frequency16    
Kansas No fixed frequency17    
Kentucky Fixed meeting frequency CAPA-CS meetings required quarterly, then twice yearly. Applies to controlled-substance agreements; CAPA-NS has no set meeting cadence.18
Louisiana No fixed frequency   CPA defines availability, consultation, coverage, and management methods.19
Maine No fixed frequency20    
Maryland No fixed frequency21    
Massachusetts No fixed frequency   Prescriptive-practice guidelines define consultation and monitoring; re-executed every 2 years.22
Michigan No fixed frequency   Requires continuous communication and regularly scheduled review/consult availability.23
Minnesota No fixed frequency24    
Mississippi No fixed frequency25    
Missouri Mixed requirements Certain contexts require in-person meetings. Telehealth can satisfy the rule in some circumstances.26
Montana No fixed frequency27    
Nebraska No fixed frequency28    
Nevada Fixed frequency + in-person Monthly onsite physician time required. Collaborating physician must spend part of a day at any APRN medical-services location to consult and monitor care quality.29
New Hampshire No fixed frequency30    
New Jersey No fixed frequency   Joint protocol defines communication methods.31
New Mexico No fixed frequency32    
New York No fixed frequency33    
North Carolina Fixed meeting frequency Monthly meetings first 6 months, then every 6 months. Meetings must be documented, signed and dated, and retained for 5 years.34
North Dakota No fixed frequency35    
Ohio No fixed frequency   SCA must include consultation and communication processes.36
Oklahoma No fixed frequency37    
Oregon No fixed frequency38    
Pennsylvania No fixed frequency   The physician must be immediately available by direct communication or telecommunication.39
Rhode Island No fixed frequency40    
South Carolina No fixed frequency   Practice agreement defines consultation; conferences may be used if chosen.41
South Dakota No fixed frequency42    
Tennessee Fixed frequency + in-person Remote-site visits required every 30 days. At least 2 visits each year must be in person; some required visits may be electronic.43
Texas Fixed meeting frequency Monthly meetings required. Parties choose the meeting format; document patient-care, care-plan, and referral discussions.44
Utah No fixed frequency45    
Vermont No fixed frequency46    
Virginia No fixed frequency47    
Washington No fixed frequency48    
West Virginia Fixed meeting frequency Annual face-to-face review/update. Board policy says the periodic joint evaluation and protocol update should be at least annual, in writing, and face to face.49
Wisconsin No fixed frequency50    
Wyoming No fixed frequency51    

Frequently Asked Questions

Does my state require an NP and collaborating physician to meet?

It depends on the state. Most jurisdictions do not set a fixed NP-physician meeting schedule. A smaller group does require recurring meetings, discussions, quality meetings, remote-site visits, onsite observation, or annual face-to-face review.

Check whether the meeting rule is tied to a specific context. Some requirements apply only in certain settings, during remote-site practice, for controlled-substance prescribing, or when the NP/APRN has not met a state-specific experience threshold.

Does "no fixed frequency" mean we never need to meet?

No. "No fixed frequency" means the state does not set a specific meeting interval in the rule summarized here. It does not mean the NP/APRN and collaborating physician should have no communication.

In many states, the collaboration agreement, protocol, standard care arrangement, or clinical workflow still needs to define consultation, availability, coverage, escalation, or quality review. In practice, the parties should still decide how they will communicate and how that process will be documented.

Are chart review requirements the same as meeting requirements?

No. Chart review and meeting requirements can overlap operationally, but they are not the same requirement. A state may require record review without requiring a meeting, or it may require meetings that include broader discussion of patient care, quality issues, referrals, or protocols.

This article only classifies meeting cadence and closely related site-visit or onsite-presence rules. For chart-review percentages, frequencies, and documentation rules, use the separate chart review guide.

Do collaborating physician meetings have to be in person?

Not usually. An NP-physician meeting has to be in person only when the rule or agreement requires physical presence, onsite review, direct observation, remote-site visits, or similar site-based language. Some states have that kind of requirement in at least certain contexts, including Alabama1, Georgia11, Missouri26, Nevada29, and Tennessee43.

The wording matters. A requirement to communicate, consult, or meet is not automatically an onsite requirement. If the rule uses site-based language, build that into scheduling and coverage; if it does not, confirm whether the state allows the meeting to happen by phone, video, or another documented communication method.

Find a collaborating physician who understands meeting requirements

Meeting requirements are practical workflow requirements. In fixed-cadence or onsite states, the physician relationship has to support scheduled touchpoints, availability, and follow-through. In no-fixed-frequency states, the agreement still needs a clear communication process.

Single Aim helps NPs and healthcare groups connect with collaborating physicians who understand state-specific collaboration requirements before the relationship starts.

Find a physician who understands NP meeting requirements

Single Aim helps NPs and healthcare groups connect with collaborating physicians and clarify state-specific meeting, availability, and collaboration expectations before the relationship starts.

Get matched with a collaborating physician

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Citations

  1. Ala. Admin. Code r. 610-X-5-.09(1), (5), (8).
  2. Alaska Stat. 08.68.850; 12 AAC 44.400-44.445.
  3. A.A.C. R4-19-508(A); Arizona Board of Nursing Scope of Practice Nurse Practitioner/APRN FAQs, updated May 2024.
  4. Ark. Code Ann. 17-87-310; 17-87-314; 17 CAR 123-603.
  5. Cal. Bus. & Prof. Code 2836.1; Cal. Code Regs. tit. 16, 1474.
  6. 3 CCR 716-1 Rule 1.14(C)(9), (C)(13)-(15), (C)(24), (G)(2)(a)-(b); C.R.S. 12-255-112(4)(b)(I)(A)-(D).
  7. Conn. Gen. Stat. 20-87a(b)(2), (b)(3).
  8. 24 Del. C. 1902(g), 1935(a)-(c); 24 Del. Admin. Code 8.4, 8.6.
  9. D.C. Code 3-1201.02, 3-1206.03; 17 DCMR ch. 59.
  10. Fla. Stat. 464.003(2), 464.012(3), 464.0123(1); Fla. Stat. 458.348(1)(a)-(b).
  11. Ga. Comp. R. & Regs. 360-32-.05(1)-(2); Ga. Comp. R. & Regs. 410-11-.14(2).
  12. Haw. Rev. Stat. 457-8.5, 457-8.6.
  13. Idaho Code title 54, ch. 14; IDAPA 24.34.01.
  14. 225 ILCS 65/65-40(d)(4); 68 Ill. Admin. Code 1300.430(b)(4); 68 Ill. Admin. Code 1285.335(b)(1)-(3).
  15. 848 IAC 5-1-1(a)(7)(D), (F), (G).
  16. Iowa Code 152.1(6); Iowa Admin. Code r. 655-7.2(1), 7.3, 7.4.
  17. K.S.A. 65-1130; Kansas H.B. 2279 (2022).
  18. KRS 314.042(12)(c)-(g), (15)(i), (15)(l)(2)-(3).
  19. La. Rev. Stat. 37:913(9); La. Admin. Code tit. 46, pt. XLVII, 4505, 4513(D); LSBME Joint Statement of Position, Collaboration and Collaborative Practice (Jan. 2016).
  20. 02-380 C.M.R. ch. 8 sec. 2(2)(A)-(D); Me. Rev. Stat. tit. 32, 2102(2-A).
  21. Md. Code, Health Occ. 8-302; COMAR 10.27.07.
  22. 243 CMR 2.10(4)(a)-(b), 2.10(5)(b); 244 CMR 4.07.
  23. MCL 333.16109(2)(a)-(c); Mich. Admin. Code R. 338.2411(1)-(2).
  24. Minn. Stat. 148.171, 148.235; Minnesota BON APRN Licensure General Information.
  25. 30 Miss. Admin. Code Pt. 2840, R. 1.1(D), (L)-(N), R. 1.4(C)-(D); Mississippi Board of Nursing, General Guidance for APRNs in Mississippi (2025).
  26. 20 CSR 2200-4.200(3)(F); Mo. Rev. Stat. 335.175; Mo. Rev. Stat. 334.104.3.
  27. Mont. Code Ann. 37-8-202, 37-8-409; ARM 24.159.1406 et seq.
  28. Neb. Rev. Stat. 38-2315, 38-2322; 172 NAC 101.
  29. NAC 630.490(7)-(9); NRS 632.237(3)-(4); NAC 632.2563(6).
  30. N.H. Rev. Stat. Ann. 326-B:11; N.H. Code Admin. R. Nur 600.
  31. N.J. Admin. Code 13:37-8.1(a), (c); N.J. Stat. 45:11-49(b)(6).
  32. N.M. Stat. Ann. 61-3-23.2; N.M. Admin. Code 16.12.2.
  33. N.Y. Educ. Law 6902(3)(a)(i)-(iii), 6902(3)(b); 8 NYCRR 64.5(a)(3).
  34. 21 NCAC 36 .0810(1), (4)(a)-(c), (5)(a)-(b).
  35. N.D. Cent. Code 43-12.1; N.D. Admin. Code 54-05-03.1.
  36. Ohio Rev. Code 4723.431(A)-(B), 4723.01(L)(1); Ohio Admin. Code 4723-8-04(D), 4723-8-05(C).
  37. OAC 435:10-13-2(a)(4), (b); Okla. Stat. tit. 59, 567.3a, 567.4a, 567.4c.
  38. ORS 678.010, 678.390; OAR 851-055-0000, 851-055-0010, 851-055-0070, 851-055-0078.
  39. 49 Pa. Code 21.251, 21.285(a)(4), 21.285(a)(7); Pennsylvania Professional Nursing Law sec. 212(13).
  40. R.I. Gen. Laws 5-34-3, 5-34-44; 216-RICR-40-05-3.
  41. S.C. Code 40-33-34(C)-(D); South Carolina BON APRN FAQ, Sept. 2019/Aug. 2025 reference copy.
  42. S.D. Codified Laws 36-9A-12.1, 36-9A-13; S.D. Admin. R. 20:62.
  43. Tenn. Comp. R. & Regs. 0880-06-.02(2), (8), (9); Tenn. Code Ann. 63-7-123(b)(5)-(6).
  44. Tex. Occ. Code 157.0512.
  45. Utah Code 58-31b-102(11), 58-31b-803(3)-(4); Utah Admin. Code R156-31b-703b.
  46. 26 V.S.A. 1613(a)(1)-(4); Vermont BON Administrative Rules 9-8, 9-9, 9-10, 9-17.
  47. 18VAC90-30-120; Va. Code 54.1-2957(D), (I); 18VAC90-30-86.
  48. RCW 18.79.250; WAC 246-840-300, 246-840-302.
  49. W. Va. Code 30-7-15b(c)(3)-(4); WV Board of Medicine Policy Statement Regarding Minimum Requirements and Guidelines for Physicians in Collaborative Relationships for Prescriptive Authority with APRNs, Guidelines (6).
  50. Wis. Admin. Code N 8.10(7).
  51. Wyo. Stat. 33-21-120; Wyoming BON APRN rules.

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Chris Turitzin
Chris, founded Single Aim Health in 2024 to provide clinicians, especially NPs and PAs, with essential services for launching and growing their practices. A Stanford graduate in Product Design, Chris co-founded Momentus Media, which was acquired by Facebook, and worked as a Product Manager there. He later gained expertise in digital health through leadership roles at Bicycle Health, Virta Health, and founding Wink Health. Now, he is using his experience to help clinicians through Single Aim Health.
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