PMHNP · North Carolina
Collaborative Practice Agreement for Psychiatric Mental Health Nurse Practitioners in North Carolina
Yes, a written physician agreement is required. North Carolina does not name a specific instrument.
NC's Nurse Practice Act and NCBON don't carve out a separate framework for psychiatric-mental-health NPs — PMHNPs follow the same collaborative-practice-agreement regime as any other NP (see the general `np` entry; N.C. Gen. Stat. § 90-18.2, 21 NCAC 36 .0810). This entry exists for its own page/URL/calculator weight, not a legal distinction — any difference from `np` here is this app's own cost-model judgment (see calculatorWeights.notes).
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
Available remotely (no on-site requirement)
Same standard as general NPs — continuous availability by direct communication or telecommunication; no on-site or mileage/minute standard is codified (21 NCAC 36 .0810).
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
new collaborative practice agreement, first 6 months: Monthly, in person or via telehealth
Same cadence as general NPs (21 NCAC 36 .0810).
ongoing, after first 6 months: Every 6 months, in person or via telehealth
The CPA itself must also be reviewed, signed, and dated at least annually.
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Same statutory framework as general NPs (21 NCAC 32M .0109): CPA must enumerate specific drugs/devices; Schedule II–III 30-day supply/no refills, Schedule IV–V up to 1-year supply with refills. PMHNP prescribing in practice skews toward Schedule II stimulants and Schedule IV benzodiazepines/hypnotics more heavily than general primary-care NP prescribing — not a different legal limit, but a different real-world risk/complexity profile (reflected in calculatorWeights below, not in this rule itself).
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same as the general `np` entry — Professional Corporation (PC) or PLLC under N.C. Gen. Stat. § 55B-14; non-licensees may not hold equity. NC's ownership statute does not distinguish PMHNPs from other NP population foci.
Legal sources for these rules (4)
What a collaborating physician costs here
Typical monthly cost in North Carolina
$500 – $800
Estimate for one Psychiatric Mental Health Nurse Practitioner. This state's rules add a restrictive-tier premium.
About North Carolina's rules
The NP 'SAVE Act' (full practice authority) has failed every session since 2021, most recently as S.B. 966 (2026) — NC NPs have no independent-practice pathway. PA 'team-based practice' (S.L. 2025-37/H.B. 67) is now LIVE: its June 30, 2026 trigger has passed, regardless of whether NCMB's conforming rules were finished by then. Several categories below (CRNA proximity/ratio/chart-review, CNM proximity) have no codified numeric standard — treat as open items to verify with the board, not an absence of one.
Other clinicians in North Carolina: see the state overview.