Can a California NP prescribe medication independently?

A California NP can prescribe medication independently if approved as a 103 NP (after completing the transition to practice) or as a 104 NP; 103 NPs may prescribe without Standardized Procedures in a group setting with at least one physician and surgeon, and 104 NPs may practice without Standardized Procedures outside a group setting subject to consultation and referral requirements¹²³.

For NPs who have not obtained 103/104 status, prescribing (furnishing or ordering) must be done under Standardized Procedures or Protocols jointly developed and approved with a supervising physician and surgeon, and the NP must complete pharmacology education; the physician and surgeon may determine the extent of supervision⁴. These procedures must specify which drugs or devices may be furnished or ordered and may include Schedule II–V controlled substances only as listed in the approved protocol⁴.

Controlled substances require additional steps: NPs who furnish controlled substances must have DEA registration and an active California furnishing number⁵. When prescribing Schedule II medications, a patient-specific protocol authorized by the treating or supervising physician and surgeon is required, NPs must complete Schedule II coursework, and a copy of the Standardized Procedure must be provided to the pharmacist upon request⁴.