PMHNP · Alabama
Collaborative Practice Agreement for Psychiatric Mental Health Nurse Practitioners in Alabama
Yes, a written physician agreement is required. Alabama does not name a specific instrument.
Alabama has no separate legal track for PMHNPs — same statute/regulations as general CRNP (Ala. Code Art. 5; Ala. Admin. Code 540-X-8/610-X-5; QACSC under 540-X-18). The only specialty artifact is a Board of Nursing 'Standard Protocol' template listing the specific skills/drugs the collaborating physician approves.
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
PMHNP with <2 years (4,000 hours) of collaborative-practice experience: On-site presence required
Identical standard to general CRNP.
PMHNP with ≥2 years (4,000 hours) of collaborative-practice experience: Available remotely (no on-site requirement)
Identical standard to general CRNP.
Supervision ratio
Up to 9 at a time (combined across provider types)
Same combined 9-FTE cap as general CRNP.
Chart review
Percentage set by agreement · Quarterly
Same quarterly QA standard as general CRNP.
Meeting cadence
Quarterly
Same quarterly cadence as general CRNP.
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Even with the same legal limit, PMHNP prescribing in practice skews toward Schedule IV benzodiazepines/hypnotics and stimulants more heavily than general primary-care CRNP prescribing — a risk/cost judgment reflected in calculatorWeights, not a different legal limit.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same as the general `np` entry — Title 10A same-profession-ownership framework.
Legal sources for these rules (2)
- Ala. Code § 34-21-81 — Advanced Practice Nursing Definitions
- Alabama Board of Nursing — Psychiatric and Mental Health CRNP Standard Protocol
What a collaborating physician costs here
Typical monthly cost in Alabama
$500 – $800
Estimate for one Psychiatric Mental Health Nurse Practitioner. This state's rules add a restrictive-tier premium.
About Alabama's rules
Alabama is a restrictive state: PA/CRNP/CNM all require an indefinite collaborative agreement with no independence pathway, and share a combined 360 hours/week (9 FTE) supervision cap per physician. CRNA's status is a genuine ambiguity — statute requires an 'immediately available' physician/dentist/podiatrist, but no filed agreement or ratio regime exists like CRNP/CNM's; flagged for legal review.
Other clinicians in Alabama: see the state overview.