CNM · Pennsylvania
Collaborative Practice Agreement for Certified Nurse-Midwives in Pennsylvania
Yes, a written physician agreement is required. Pennsylvania does not name a specific instrument.
A nurse-midwife may not engage in midwifery practice without a written Collaborative Agreement filed with the State Board of Medicine (49 Pa. Code Chapter 18, Subchapter A) — no experience- or hours-based pathway to independent practice was found.
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)
The Collaborative Agreement must address the circumstances appropriate to the practice setting; no statewide mile/minute radius or on-site requirement is codified.
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
Separate prescribing terms required · controlled substances permitted
May prescribe, dispense, order, and administer medical devices, immunizing agents, and therapeutic/diagnostic/preventive measures consistent with AMCB certification and the Collaborative Agreement. Specific controlled-substance schedule limits were not separately confirmed in this research pass.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same physician/licensee-only ownership regime as the general `pa`/`np` entries — no CNM-specific independent-ownership statute was found in this research pass.
Legal sources for these rules (1)
What a collaborating physician costs here
Typical monthly cost in Pennsylvania
$500 – $600
Estimate for one Certified Nurse-Midwife. Standard-tier state.
About Pennsylvania's rules
Pennsylvania has no independent-practice pathway for CRNPs — SB 25-style full-practice-authority bills have been introduced every session without passing. PA (physician assistant) reform via Acts 78/79 of 2021 removed prior Board pre-approval of written agreements and the flat 100%-countersignature rule after the first year, but a written agreement and supervision remain mandatory. PA is a CPOM state: only licensed physicians may own a medical professional corporation.
Other clinicians in Pennsylvania: see the state overview.