Hawaii
PMHNP Practice Requirements In Hawaii: Scope, Prescribing & Collaboration
Short answer: AANP lists Hawaii as full practice, so a PMHNP recognized by the Hawaii Board of Nursing diagnoses, prescribes and institutes therapy without any physician collaboration requirement in the nurse practice act (HRS 457-8.5, 457-8.6). Qualified APRNs prescribe legend drugs and controlled substances under chapter 329, and Act 153 (2018) requires prescribers to check the Hawaii PDMP before prescribing a Schedule II, III or IV drug.
Hawaii PMHNP Rules At A Glance
| Topic | Hawaii Rule |
|---|---|
| Practice authority | Full practice. The Board of Nursing grants APRN recognition to nurses with graduate education and national certification, and HRS 457-8.6(d) authorizes qualified APRNs to diagnose, prescribe and institute therapy or referrals. |
| Physician agreement | None. HRS 457-8.5 and 457-8.6 set education, certification and advanced pharmacology requirements for recognition and prescriptive authority and contain no physician supervision or collaboration requirement. |
| Physician limit | Not applicable. Hawaii doesn’t require a collaborating or supervising physician, so there’s no ratio to track and no supervised hours period before independent practice (HRS 457-8.5, 457-8.6). |
| Controlled substances | Qualified APRNs may prescribe and administer over the counter drugs, legend drugs and controlled substances under chapter 329, within the board’s exclusionary formulary; APRNs may not sign for controlled substance samples (HRS 457-8.6(d)). |
| PDMP | Every controlled substance registrant must register with the Hawaii PDMP as part of the registration process (HRS 329-101(b)), and Act 153 (2018) requires prescribers to consult it before prescribing a Schedule II, III or IV controlled substance. |
| Regulator | Hawaii Board of Nursing, under the Department of Commerce and Consumer Affairs. The Narcotics Enforcement Division issues the state controlled substance registration and runs the PDMP. |
Updated October 5, 2026
Practice Authority
Hawaii Practice-Authority Category (Full Practice)
AANP currently classifies Hawaii as a full practice state on its State Practice Environment map. A PMHNP in Hawaii can evaluate and diagnose patients, order and interpret tests, and start and manage treatment, including prescribing, under the exclusive licensure authority of the Hawaii Board of Nursing. There’s no state-mandated career-long collaborative or supervisory agreement.
For the national comparison, the AANP State Practice Environment map and AANP’s practice information by state show where Hawaii sits. The binding rules come from the Hawaii Board of Nursing.
Collaboration
Is A Collaborative Or Supervisory Agreement Required?
Once you’re licensed, Hawaii doesn’t make you keep a career-long collaborative or supervisory agreement. The question for a new NP is the first stretch of practice. Some full practice states require a defined transition-to-practice period of supervised or collaborative practice before fully independent practice, and whether one applies to you in Hawaii, how long it lasts and how it’s documented all come from state rule.
Our guide to PMHNP collaborative practice agreements covers what these agreements usually contain, and the PMHNP scope of practice by state overview puts Hawaii side by side with every other state.
Prescriptive Authority
Prescriptive Authority And Controlled Substances
Meet the requirements in Hawaii and you can be granted prescriptive authority, which can reach controlled substances once the conditions are met. To prescribe those, you’ll need your own federal DEA registration, and some substances carry additional federal or state conditions. Federal registration goes through the U.S. Drug Enforcement Administration. On the state side, state law and the rules of the Hawaii Board of Nursing set the scope, any limits and the documentation.
Next Step
Credentialing Is A Separate Track
Practice authority decides what you can do in Hawaii. It doesn’t get you paid. Payer enrollment runs on its own track, with its own payer rules, Medicaid program and timelines, and our Hawaii credentialing and payer enrollment guide covers it. For the national picture, read the PMHNP credentialing guide.
If you’re opening your own practice, order matters. Our guide on how to start a PMHNP practice and the 90-day launch checklist walk through licensure, collaboration and enrollment in sequence. Once the order is clear, work out the budget with what PMHNP credentialing costs and what it costs to start a PMHNP practice.
If you’d rather hand us the work, First Practice Launch sets up a first practice’s payers, EHR, portals and billing for $6,000, or four monthly payments of $1,500. Joining a clinic instead? New Provider Credentialing covers five commercial payers for $2,750 per provider, and you can start with one payer.
FAQ
Frequently Asked Questions
Can A PMHNP Practice Independently In Hawaii?
Yes. Once the Board of Nursing recognizes you as an APRN under HRS 457-8.5, you may diagnose, prescribe and institute therapy within your specialty without a physician agreement (HRS 457-8.6(d)). Hawaii has no supervised hours period before independent practice.
Can A PMHNP Prescribe Adderall In Hawaii?
Yes, once you hold prescriptive authority, a Hawaii controlled substance registration from the Narcotics Enforcement Division and DEA registration. HRS 457-8.6(d) covers controlled substances prescribed under chapter 329, subject to the board’s exclusionary formulary. Because stimulants are Schedule II, Act 153 (2018) requires a PDMP check before you prescribe.
Do I Have To Check The PDMP Before Prescribing In Hawaii?
Yes, for Schedule II, III and IV. Act 153 (2018) requires prescribers to consult the Hawaii PDMP before prescribing those drugs to reduce the risk of misuse and harmful interactions, with narrow exceptions set out in the Act. Registration with the PDMP is part of the state controlled substance registration process (HRS 329-101(b)).
This is general information, not legal advice. It applies the general nurse practitioner rules in Hawaii to PMHNPs, and those rules aren’t the same for every role. Rules change, so check with the Hawaii Board of Nursing and the AANP State Practice Environment map before you act on it. Last reviewed: September 26, 2026.
Keep Reading
Related PMHNP Resources
Scope By State
Compare requirements across states on our PMHNP scope of practice by state overview.
Start A Practice
See the full sequence in how to start a PMHNP practice.
Credentialing
Learn what we handle on our PMHNP credentialing page, or visit the PMHNP services hub.
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