NP · Maryland
Collaborative Practice Agreement for Nurse Practitioners in Maryland
Not unconditionally. Maryland does not name a specific instrument.
The 2015 Nurse Practitioner Full Practice Authority Act eliminated the prior mandatory physician-attestation/collaboration requirement. The mentorship is informal (no written agreement filed) and time-bound, not indefinite — after 18 months (or immediately, if already certified elsewhere) the NP practices fully independently.
Independent practice requires: 18 months of mentorship (available consultation/collaboration) from a Maryland-licensed physician or NP with ≥3 years' clinical experience — ONLY required for an NP never previously certified in Maryland or any other state; an NP already certified elsewhere is exempt from this mentorship entirely and practices independently from initial MD certification.
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
first-time NP (never certified in any state) during the 18-month mentorship: Available remotely (no on-site requirement)
The mentor need only be 'available for advice, consultation, and collaboration, as needed' — no on-site or fixed-radius standard.
after the 18-month mentorship, or any NP already certified in another state: No proximity requirement
No physician availability/proximity standard applies once independent.
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
Schedule II-V. Schedule II-III prescriptions are capped at a 30-day supply per single filling under Maryland's general controlled-substance dispensing limits. Requires Maryland CDS registration and federal DEA registration.
Written agreement
Not required
No written collaborative practice agreement is required at any point — even the 18-month first-time-NP mentorship is an informal consultation relationship, not a filed agreement.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Maryland does not recognize PLLCs, and medical-services Professional Corporations are limited to physician shareholders — no independent NP practice-entity ownership pathway was confirmed in this pass. Treat as an open item rather than a settled fact given NPs' full clinical independence.
This ownership question is legally distinct from the clinical independence granted by the 2015 Act above.
What a collaborating physician costs here
Typical monthly cost in Maryland
$500 – $600
Estimate for one Nurse Practitioner. 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.