CNM · South Dakota
Collaborative Practice Agreement for Certified Nurse-Midwives in South Dakota
Yes, a written physician agreement is required. South Dakota does not name a specific instrument.
Same SDCL 36-9A framework and threshold as general `np`. Newly-licensed CNMs practicing on a temporary permit may separately need a Board-filed 'supervisory agreement' with a physician/CNM for that temporary-permit period — a distinct, narrower requirement from the ongoing 1,040-hour threshold above.
Independent practice requires: ≥1,040 practice hours as a licensed CNM (or CNP); until then, a written collaborative agreement with a physician OR an already-independent CNP/CNM (SDCL 36-9A-4(5)).
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
Not codified — left to the agreement
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
SDCL 36-9A-13(5)(b): same 'Schedule II in chapter 34-20B' language as general NPs — see that entry's note on the unresolved Schedule III–V ambiguity.
Written agreement
Required
Only pre-1,040-hour CNMs need the written collaborative agreement; once met, no ongoing agreement is required (see general `np` entry for the identical mechanism).
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same as the general `np` entry — not directly confirmed in this research pass.
Legal sources for these rules (2)
What a collaborating physician costs here
Typical monthly cost in South Dakota
$500 – $600
Estimate for one Certified Nurse-Midwife. Standard-tier state.
About South Dakota's rules
SD is unusually permissive: NP/CNM need only 1,040 practice hours (or a collaborative agreement with ANY physician OR already-independent NP/CNM) to become fully independent (SDCL 36-9A), and a 2025 reform (SL 2025, ch 149) gives PAs the same kind of pathway after 6,000 hours plus NCCPA certification. Older sources citing a fixed PA-per-physician ratio are now outdated — that cap was repealed.
Other clinicians in South Dakota: see the state overview.