CNM · Kentucky
Collaborative Practice Agreement for Certified Nurse-Midwives in Kentucky
Yes, a written physician agreement is required. Kentucky does not name a specific instrument.
Kentucky has no midwifery-specific independent-practice statute comparable to NC's S.L. 2023-14 — CNMs are simply one of the four APRN roles under KRS 314.042, with the same diagnosis/treatment independence and the same CAPA-NS/CAPA-CS prescribing gates as general NPs.
Independent practice requires: same ≥4-year CAPA-NS and ≥4-year CAPA-CS thresholds as general NPs (KRS 314.042) — CNMs share the identical APRN prescribing framework.
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 supervision requirement for clinical midwifery practice; no proximity standard codified for the CAPA relationship itself.
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
nonscheduled legend drugs, before 4 years under a CAPA-NS: Separate prescribing terms required · no controlled-substance authority
Same statutory framework as general NPs (KRS 314.042).
Schedule II–V controlled substances, before 4 years under a CAPA-CS: Separate prescribing terms required · controlled substances permitted
Requires individual DEA registration and KASPER enrollment, same as general NPs.
after the applicable 4-year CAPA-NS/CAPA-CS threshold is met: Covered by the practice agreement · controlled substances permitted
Same independent-exit mechanism as general NPs.
Written agreement
Required
Same branch as general NP: no agreement needed to diagnose/treat/deliver care within midwifery scope; CAPA-NS and CAPA-CS are each required only for their respective prescribing category, each independently exitable after 4 years (KRS 314.042).
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional LLC (KRS Ch. 275) or PSC (KRS Ch. 274) — CNMs, as nurses, are explicitly eligible independent owners; no physician ownership required.
Legal sources for these rules (2)
What a collaborating physician costs here
Typical monthly cost in Kentucky
$500 – $600
Estimate for one Certified Nurse-Midwife. This state's proximity rules add a small premium.
About Kentucky's rules
KY's PSC/PLLC statutes (KRS Ch. 274, 275) are commonly read to restrict ownership to persons rendering the 'same or related' professional service — a physician generally cannot co-own a single PSC/PLLC with a PA or APRN, unlike NC/VA's explicit combination statutes. Secondary-sourced interpretation, not a confirmed ruling — verify before relying on it. Kentucky opted out of the federal Medicare CRNA supervision requirement in April 2012; facilities may still impose their own.
Other clinicians in Kentucky: see the state overview.