Can a Texas NP prescribe controlled substances without supervision?

No. Texas NPs cannot prescribe controlled substances without supervision; controlled-substance prescribing must be delegated by a physician under a prescriptive authority agreement¹. Delegation covers Schedules III–V² and Schedule II in limited settings³.

For Schedules III–V, delegation is permitted only with safeguards: each prescription (including refills) may not exceed 90 days, refills require prior consultation with the delegating physician and documentation in the chart, and prescribing for children under two requires physician consultation documented in the chart².

Schedule II prescribing may be delegated only in a hospital facility-based practice or as part of hospice care for a terminally ill patient under a written certification and plan of care³. The Texas Board of Pharmacy further advises that an APRN may prescribe Schedule II only if they hold appropriate DEA registration and have a Prescriptive Authority Agreement authorized by the Texas Medical Board⁴. While supervision is required, the physician need not be physically present at all times to provide adequate oversight⁵.