CNM · Indiana
Collaborative Practice Agreement for Certified Nurse-Midwives in Indiana
Yes, a written physician agreement is required. Indiana does not name a specific instrument.
Certified nurse midwives are APRNs under IC 25-23-1-1(b)(2) and carry the same career-long practice-agreement requirement as NPs, with no CNM-specific carve-out or hours-based pathway. NOT to be confused with Indiana's separately regulated, non-nurse Certified Direct Entry Midwife (IC 25-23.4; rules at 844 IAC 17) — a different credential under a different board, out of scope for this entry, and a frequent source of conflation in secondary summaries.
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
Same as `np` — no codified proximity or reachability rule; 848 IAC 3-3-1 (competent practice of nurse-midwives) imposes professional-judgment consultation and referral standards but no physician-presence or distance requirement, and contains no written-agreement mandate of its own (the agreement requirement comes from IC 25-23-1-19.4(c)).
Supervision ratio
Not codified — no cap on file
Chart review
5% of charts · As needed (documentation of prescribing practices submitted to the collaborating practitioner within 7 days)
Same 848 IAC 5-1-1(a)(7) requirement as `np`. Applies to CNMs who hold prescriptive authority; a non-prescribing CNM still needs a practice agreement under IC 25-23-1-19.4(c) but is not subject to this sampling rule.
Meeting cadence
Every 6 months, in person or via telehealth
Same two-year prescriptive-authority renewal/agreement-refresh cycle as `np` (IC 25-23-1-19.5(c); 848 IAC 5-1-3).
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
848 IAC 5-1-1(a)(5) names 'certified nurse-midwife' as one of the two national certifications that satisfy the baccalaureate-only alternative track, so CNM prescriptive authority is squarely available (contrast `cns`, where that same subdivision's silence leaves an open question). No freestanding-birth-center facility rules were reviewed in this pass — if Indiana has any, they could add facility-level requirements beyond this provider-level entry, the same caveat carried on the Colorado and Texas CNM entries.
Written agreement
Required
Unconditional. IC 25-23-1-19.4(c) requires an APRN to 'operate in collaboration with a licensed practitioner as evidenced by a practice agreement,' or alternatively under privileges granted by a hospital governing board — the agreement requirement attaches to APRN practice generally, not only to prescribing. Note the asymmetry in enforcement: the biennial random audit at IC 25-23-1-19.8(a) reaches only APRNs who hold prescriptive authority under IC 25-23-1-19.5, and only prescribers must file their agreement with the board (848 IAC 5-1-1(a)(7)). A non-prescribing APRN still needs an agreement under § 19.4(c) but has no filing or audit obligation attached to it.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Stronger footing than the other APRN entries: IC 25-22.5-1-2(a)(22)(H) names 'a certified nurse midwife' EXPRESSLY in the health-care-organization ownership list, so this entry does not depend on the inferred 'registered nurse' reading used for `np`/`pmhnp`/`cns`/`crna`. A non-licensee still cannot own such an entity — the list is a licensed-profession gate.
The same subdivision separately names 'a certified direct entry midwife,' confirming Indiana treats the two midwifery credentials as distinct throughout. This analysis governs entity ownership only. It does not extend to any service outside the APRN's own scope — notably delegated medical-aesthetic procedures, which stay under the delegating physician's control via IC 25-22.5-1-2(a)(20) regardless of who owns the entity (see the `esthetician` entry).
Legal sources for these rules (5)
- IC 25-23-1-1(b)(2) — certified nurse midwife as an APRN, and IC 25-23-1-1.1 / -13.1 on CNM licensure (Justia archived 2014 Indiana Code chapter PDF)secondary
- IC 25-23-1-19.4, 25-23-1-19.5 — same APRN collaboration and prescriptive-authority framework as `np` (FindLaw mirror, current as of 1/1/2026)secondary
- 848 IAC 3-3-1 — Competent Practice of Nurse-Midwives (Cornell LII Indiana Administrative Code mirror; imposes no physician-agreement or proximity rule of its own)secondary
- IC 25-22.5-1-2(a)(22)(H) — 'a certified nurse midwife' named expressly in the health-care-organization ownership list, alongside a separate reference to certified direct entry midwives (FindLaw mirror, current as of 1/1/2026)secondary
- IC 25-23.4 — Certified Direct Entry Midwives (cited ONLY to mark the boundary of this entry; a separate non-nurse credential, not covered here)
What a collaborating physician costs here
Typical monthly cost in Indiana
$500 – $650
Estimate for one Certified Nurse-Midwife. This state's rules add a restrictive-tier premium.
About Indiana's rules
Indiana requires a career-long collaborative practice agreement for every APRN role except CRNAs (IC 25-23-1-19.4(c)); APRN prescribers additionally face a codified 5%-of-charts random-sampling review (848 IAC 5-1-1). CRNAs instead face a stricter rule — physician direction and immediate presence (IC 25-23-1-30). Widely repeated reports that Indiana enacted full practice authority in 2026 are unsupported: HB 1116, HB 1129 and SB 60 all failed. Indiana's corporate-practice doctrine is comparatively permissive.
Other clinicians in Indiana: see the state overview.