CNM · Maryland
Collaborative Practice Agreement for Certified Nurse-Midwives in Maryland
No. Certified Nurse-Midwives practice independently here. Maryland does not require one.
Maryland's full practice authority extends to CNMs alongside CRNPs — a CNM independently manages clients within their clinical practice guidelines and 'may consult or collaborate with a physician or other health care provider as needed' rather than as a mandatory precondition to practice.
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 mandatory physician availability/proximity standard — collaboration is clinician-directed and as-needed, not a fixed requirement.
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 Maryland CDS registration and federal DEA registration; exact schedule-level limits beyond the general 30-day Schedule II-III dispensing cap were not independently confirmed in this pass.
Written agreement
Not required
Unconditional — consultation/collaboration is described as needed/permissive, not a required written agreement, per COMAR 10.27.05.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same open item as the general `np` entry.
Legal sources for these rules (1)
What a collaborating physician costs here
Typical monthly cost in Maryland
$500 – $600
Estimate for one Certified Nurse-Midwife. Standard-tier state.
About Maryland's rules
Maryland's APRN categories are NOT uniform: CRNPs/CNMs gained full practice authority in 2015 (after an 18-month new-graduate mentorship), but CRNAs remain fully supervised with NO prescriptive authority at all (Maryland is one of ~11 states granting CRNAs none), and only the psychiatric-mental-health population focus of CNS practice is independent. Maryland does not recognize PLLCs — professional entities use physician-only Professional Corporations, so multi-disciplinary PC ownership questions are open items below.
Other clinicians in Maryland: see the state overview.