NP · Texas
Collaborative Practice Agreement for Nurse Practitioners in Texas
Yes, a written physician agreement is required. Texas calls it a Prescriptive Authority Agreement (PAA).
Texas remains a restricted-practice state with no independent-practice pathway for NPs at any experience level — confirmed by AG Opinion KP-0266 (2019) and BON's own APRN Scope of Practice Decision-Making Model. A 2025 rural 10-year/20,000-hour pathway bill (S.B. 3055) died in committee, as did 2023's full-practice-authority S.B. 1700.
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 mileage/radius or continuous-availability standard is codified; TMB treats distance between practice sites as one factor in judging 'adequate supervision,' not a fixed rule.
Supervision ratio
Up to 7 at a time (combined across provider types)
Same combined APRN+PA cap as the `pa` entry (§ 157.0512(c)) — one physician's total roster, not 7 NPs specifically. No cap at a facility-based hospital practice or medically-underserved site (§ 157.0512(d)).
Chart review
Not codified — left to the agreement
Meeting cadence
Monthly, in person or via telehealth
At least monthly (§ 157.0512(e)(9)(B), (f)), method flexible since H.B. 278 (2019) removed the prior in-person requirement. Chart review is required as part of the agreement's QA process, with the number of charts 'determined by the physician and advanced practice registered nurse' — no fixed percentage is codified (the commonly-cited 10% figure predates the 2013 restructuring and is obsolete).
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Requires individual DEA registration only (no separate DPS registration since S.B. 195, 2015). Texas statute also requires ≥2 hours annual CE on pain management/drug-seeking-behavior identification for APRNs with opioid-prescribing authority (§ 157.0513(a)(4)); a further BON CE-hour figure for controlled-substance prescribing generally was reported in secondary sources but its exact current rule citation could not be confirmed in this research pass — flag as unconfirmed if load-bearing.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — No Texas statute lists APRNs (NP/PMHNP/CNM/CRNA/CNS) among the professionals eligible for physician joint-ownership under Tex. Bus. Orgs. Code § 301.012 — unlike PAs (see that entry), NPs have no statutory ownership pathway into a medical PA/PLLC at all, not even a minority one. An NP may own a nursing-scope-only entity under § 301.003's same-profession rule, but full-scope prescribing practice requires a physician-owned structure.
Legal sources for these rules (8)
- Tex. Occ. Code § 157.0511
- Tex. Occ. Code § 157.0512
- Tex. Occ. Code § 157.0513
- Tex. Bus. Orgs. Code § 301.012
- 22 Tex. Admin. Code § 221.13(d) — BON, APRN practice standards
- Texas Board of Nursing — APRN Scope of Practice Decision-Making Model
- Tex. Att'y Gen. Op. KP-0266 (2019)
- S.B. 3055 (89th Leg., 2025) — rural independent-practice pathway, died in committee
What a collaborating physician costs here
Typical monthly cost in Texas
$600 – $900
Estimate for one Nurse Practitioner. This state's rules add a restrictive-tier premium.
About Texas's rules
Texas has no independent-practice pathway for any APRN type (NP/PMHNP/CRNA/CNM/CNS) at any experience level — a 2025 rural 10-year/20,000-hour bill (S.B. 3055) died in committee, as did 2023's full-practice-authority S.B. 1700. No chart-review percentage is codified (the physician and provider set the number themselves) — the commonly-cited 10%/20% figures reflect a pre-2013 rule since repealed. PA is the only non-physician profession with a statutory joint-ownership pathway into a medical entity.
Other clinicians in Texas: see the state overview.