Alabama
PMHNP Practice Requirements In Alabama: Scope, Prescribing & Collaboration
Short answer: AANP lists Alabama as reduced practice, so a PMHNP works under a collaborative practice agreement with a physician who must be on site for at least 10% of scheduled hours until the CRNP logs two years and 4,000 hours (Ala. Admin. Code 610-X-5-.09). Schedule III to V prescribing needs a QACSC from the Board of Medical Examiners, and Schedule II stimulants need a separate Limited Purpose Schedule II Permit.
Alabama PMHNP Rules At A Glance
| Topic | Alabama Rule |
|---|---|
| Practice authority | Reduced practice. A CRNP practices under a collaborative practice agreement with an Alabama physician, approved jointly by the Board of Nursing and the Board of Medical Examiners (Ala. Code 34-21-81 et seq.; Ala. Admin. Code 610-X-5). |
| Physician agreement | Required. The collaborating physician must be present for at least 10% of your scheduled hours until you have two years and 4,000 hours, then meet with you quarterly, and complete quarterly quality assurance (610-X-5-.09(5)). |
| Physician limit | A physician may collaborate with or supervise no more than 360 hours a week of CRNP, CNM and PA time combined, which the rule defines as nine full time equivalents (610-X-5-.05(1)). |
| Controlled substances | Schedule III to V need a QACSC from the Board of Medical Examiners, limited to a 30 day supply with two refills before physician review. Schedule II, including stimulants, needs a separate Limited Purpose Schedule II Permit (ABME protocols). |
| PDMP | QACSC and LPSP holders must keep an active registration with the Alabama PDMP to renew, and the collaborating physician’s quarterly review of your controlled substance prescribing can include your PDMP report (ABME QACSC protocol, item 7). |
| Regulator | The Alabama Board of Nursing approves CRNP practice and, through a Joint Committee with the Board of Medical Examiners, the collaborative agreement. The Board of Medical Examiners issues the QACSC and the LPSP. |
Updated October 5, 2026
Practice Authority
Alabama Practice-Authority Category (Reduced Practice)
The American Association of Nurse Practitioners (AANP) currently classifies Alabama as a reduced practice state. In practice, a PMHNP in Alabama works under a required collaborative relationship with a physician for at least some elements of practice, including aspects of prescribing.
Collaboration
Is A Collaborative Or Supervisory Agreement Required?
Before you provide the full scope of care in Alabama, you’ll generally need a collaborative relationship or agreement with a physician for at least some functions. What that agreement must contain, how it’s documented and how often it’s reviewed all come from state rule.
Prescriptive Authority
Prescriptive Authority And Controlled Substances
Prescriptive authority in Alabama comes once you meet the state’s requirements, and it can include controlled substances when the conditions are met. You’ll also need a separate federal DEA registration for those, and some carry additional conditions. State law and board rule set the scope and documentation. The U.S. Drug Enforcement Administration covers the federal side.
Next Step
Credentialing Is A Separate Track
None of this gets you paid on its own. Credentialing in Alabama is a separate track with its own payer rules, Medicaid program and enrollment timelines, and the Alabama credentialing and payer enrollment page covers it in detail. For the national view, see our PMHNP credentialing guide.
Going out on your own? Our guide on how to start a PMHNP practice covers licensure, collaboration and enrollment in the order they have to happen. As you plan your finances, read what PMHNP credentialing costs and what it costs to start a PMHNP practice.
If you want help with the setup itself, First Practice Launch handles payer enrollment, the EHR, portals and billing for a first practice at $6,000, or four monthly payments of $1,500.
FAQ
Frequently Asked Questions
Can A PMHNP Practice Independently In Alabama?
No. Alabama is a reduced practice state, and every CRNP practices under a collaborative practice agreement with a physician (Ala. Code 34-21-81 et seq.). There’s no hours based path to independent practice. After two years and 4,000 hours the physician presence requirement drops from 10% of your hours to quarterly meetings, but the agreement stays (Ala. Admin. Code 610-X-5-.09).
Can A PMHNP Prescribe Adderall In Alabama?
It depends on your permits. Stimulants are Schedule II, so a QACSC alone (Schedule III to V) isn’t enough; you need a Limited Purpose Schedule II Permit from the Board of Medical Examiners that lists the specific drugs, and only drugs customary in your collaborating physician’s specialty are approved. Under the LPSP protocol you may write an initial 30 day supply and two reissues, then the physician must see the patient before further reissues.
How Many Nurse Practitioners Can One Physician Collaborate With In Alabama?
It depends on hours, not headcount. A physician may collaborate with or supervise up to 360 hours a week of CRNP, CNM and PA time combined, which the rule calls nine full time equivalents (Ala. Admin. Code 610-X-5-.05). A physician with more than four FTEs must do documented monthly quality assurance with each new CRNP for the first six months, and the Joint Committee can approve extra positions on request.
This is general information, not legal advice. It applies the general nurse practitioner rules in Alabama to PMHNPs. Rules change, so check with the Alabama Board of Nursing and the AANP State Practice Environment map before you act on it. Last reviewed: September 26, 2026.
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