CNS · District of Columbia
Collaborative Practice Agreement for Clinical Nurse Specialists in District of Columbia
No. Clinical Nurse Specialists practice independently here. District of Columbia does not require one.
D.C. Code § 3-1206.07b specifically expanded CNS scope alongside the general § 3-1206.03 repeal — a CNS may practice their full scope without a collaborating-physician relationship.
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
No proximity requirement
No physician availability/proximity standard applies post-HORA 2024.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Requires DEA registration and a DC controlled-substance registration; exact schedule-level limits not independently confirmed in this pass.
Written agreement
Not required
Unconditional as of HORA 2024.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same open item as the general `np` entry — no confirmed independent-ownership statute for APRN practice entities under the Board of Nursing.
Legal sources for these rules (2)
- D.C. Code § 3-1206.07b — Clinical Nurse Specialist scope of practice
- D.C. Code § 3-1206.03 [Repealed by D.C. Law 25-191 (HORA 2024)]
What a collaborating physician costs here
Typical monthly cost in District of Columbia
$500 – $600
Estimate for one Clinical Nurse Specialist. Standard-tier state.
About District of Columbia's rules
The Health Occupations Revision Amendment Act of 2024 repealed D.C. Code § 3-1206.03, eliminating the collaboration mandate for all APRN categories (NP/PMHNP/CRNA/CNM/CNS) — DC is now a full-practice-authority jurisdiction for APRNs. PAs are NOT covered by that reform and still require a Board of Medicine Delegation Agreement regardless of experience; no autonomous-PA pathway was found in DC as of this pass.
Other clinicians in District of Columbia: see the state overview.