Nurse Practitioner Collaborative Agreements in North Carolina

Comprehensive guides, directories, and tools for Nurse Practitioners and physicians forming collaborative agreements or prescriptive authority agreements in North Carolina.
Written by
Chris Turitzin
Founder, Single Aim
.
Updated May 05, 2026

North Carolina Collaborative Agreement Summary

Collaboration Difficulty Level

Medium

Collaborating Physician Pay

$600 - $950/m

Capacity Limits:
no set maximum number

Meeting Requirements

Monthly first 6 mo; every 6 mo after

Board submissions

Required

Distance Restrictions

None fixed; supervision must fit practice
North Carolina Regulatory Considerations
Six-month QI meetings and documentation
Monthly first-six-month meetings
Board approval to practice required

North Carolina Collaborative Agreement Templates

North Carolina NP collaboration is documented through a collaborative practice agreement with a primary supervising physician. The agreement should identify the drugs, devices, medical treatments, tests, and procedures the NP may prescribe, order, or perform at each practice site, and it must include a predetermined plan for emergency services.1

The agreement is not just a one-time form. North Carolina requires annual review with a dated signature sheet, ongoing availability for consultation, a written quality-improvement plan, monthly meetings during the first six months, and quality-improvement meetings at least every six months after that.1 Practical examples are available from UNC School of Medicine and the North Carolina Psychiatric Association.

Citations
1. 21 NCAC 36 .0810.

North Carolina Templates

Explore a collection of publicly shared CPA examples used by organizations across North Carolina. These can help you understand common structures and language when creating your own agreement.

North Carolina Agreement Contents

See a breakdown of what North Carolina law requires in all Collaborative Practice Agreements.

Submitting the Agreement to the State

In North Carolina, NP registration alone does not authorize practice. The NP must use the Board of Nursing's Nurse Practitioner applications page or Nurse Portal to submit an Initial Approval to Practice, or the combined Registration & Initial Approval to Practice application, with supervising-physician and practice-site information.

NP practice begins after the Board of Nursing sends final approval. After approval, the Board's Physician Maintenance workflow is used to add or remove a supervising physician, add practice sites, or update approved practice information; the signed collaborative practice agreement is maintained onsite, reviewed annually, and supported by documented QI meetings.

North Carolina collaborative agreement process

North Carolina Collaborative Agreement FAQ

Understanding the specific requirements and regulations for collaborative practice agreements in North Carolina is crucial for both Nurse Practitioners and physicians. Below are the most frequently asked questions about North Carolina collaborative agreements, organized by topic to help you navigate the requirements, physician responsibilities, and NP scope of practice.

North Carolina Collaborative Practice Agreement (CPA) Details

Collaboration & Supervision Requirements

Prescriptive Authority (Medications & Controlled Substances)

Scope of Practice

North Carolina Collaborating Physician Pay

One of the most important considerations when establishing a collaborative agreement is compensation. Understanding the market rate for collaborating physicians in North Carolina helps ensure fair compensation and successful partnerships. Based on our comprehensive analysis of pay data across the state, here's what you can expect.

⚠️   Special Note: Structured North Carolina oversight Fees may stay lower than in high-complexity states, but approval-before-practice, monthly first-six-month meetings, six-month QI meetings, and annual CPA review can still add physician oversight work.

Average Monthly Compensation
$706
per month
Compensation Range
Low Range
$600
per month
Average
$706
per month
High Range
$950
per month
North Carolina collaborating physician pay chart
Compensation varies based on factors including practice setting, number of NPs supervised, chart review requirements, and additional responsibilities. Physicians collaborating with multiple NPs or providing more intensive oversight typically command higher monthly fees.
How did we calculate pay?

Find a Collaborating Physician in North Carolina

Securing a collaborating physician is one of the most critical steps in establishing your practice as a North Carolina Nurse Practitioner. Rather than spending weeks reaching out to individual physicians or relying on personal networks, the Single Aim platform provides direct access to qualified, board-certified physicians who are actively seeking collaboration opportunities.

The Single Aim network has 34 vetted physicians licensed in North Carolina ready to take on your collaborating physician job.

About the Author

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.
Learn more about launching and growing your practice as an NP or PA
By clicking “Subscribe” you agree to Single Aim Privacy Policy and consent to Single Aim using your contact data for newsletter purposes.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.