Maryland
PMHNP Practice Requirements In Maryland: Scope, Prescribing & Collaboration
Maryland is a full practice state, so a PMHNP diagnoses, treats and prescribes without a physician agreement, though a first-time nurse practitioner has to name a mentor for the first 18 months. Controlled substances take a Maryland CDS registration before your DEA registration, and you have to be registered with the state PDMP before that CDS registration is issued.
| At A Glance | Maryland |
|---|---|
| Practice Authority | Full practice (AANP). Health Occupations § 8-101(m) lets a nurse practitioner diagnose, order tests and prescribe independently. |
| Physician Agreement | None. Maryland repealed its physician attestation requirement on October 1, 2015. |
| New NP Mentor | A first-time NP names a mentor (an NP or physician with 3 or more years of practice) for 18 months, under § 8-302.1(d)(1). |
| Controlled Substances | Maryland CDS registration first, then DEA, under Criminal Law § 5-301. |
| PDMP | Register before your CDS registration. Check at least 4 months of history before starting an opioid or benzodiazepine, then at least every 90 days. |
| Regulator | Maryland Board of Nursing (COMAR 10.27.07). |
Updated September 26, 2026
Practice Authority
Maryland Practice-Authority Category (Full Practice)
The American Association of Nurse Practitioners (AANP) currently classifies Maryland as a full practice state, and the statute says the same thing. Health Occupations § 8-101(m) defines NP practice as independently assessing patients, diagnosing, ordering and interpreting lab tests, prescribing under § 8-508, and consulting, collaborating or referring as needed. COMAR 10.27.07.03 lists those functions, prescribing included, under the licensure authority of the Maryland Board of Nursing. There’s no physician agreement to sign.
Collaboration
Is A Collaborative Or Supervisory Agreement Required?
No. Until October 1, 2015, a Maryland NP needed a Board-approved attestation of an agreement for collaboration and consulting with a physician. Chapter 468 of the 2015 Laws of Maryland repealed it. What’s left is a duty to practice under the standards of the American Association of Nurse Practitioners or another certifying body the Board recognizes, plus a mentor for first-time NPs. Employers, facilities and payers can still ask for their own paperwork, but that’s their policy, not state law.
New Nurse Practitioners
Does Maryland Require A Mentor For New Nurse Practitioners?
Yes, if you’ve never been certified as a nurse practitioner by Maryland or any other board of nursing. Health Occupations § 8-302.1(d)(1) has you name a mentor on your certification application, and the mentor consults and collaborates with you for 18 months from the day the Board receives that application. Under § 8-101(j) the mentor is a certified registered nurse practitioner or a licensed physician with 3 or more years of clinical practice experience. The statute describes the relationship as consulting and collaborating as needed. An NP already certified by another state’s board doesn’t need one.
Prescriptive Authority
Prescriptive Authority And Controlled Substances
Maryland NPs prescribe under Health Occupations § 8-508, and controlled substances need two registrations. Criminal Law § 5-301 requires registration with the Maryland Department of Health before you dispense a controlled dangerous substance, and § 5-101 counts prescribing as dispensing. The Office of Controlled Substances Administration issues that CDS registration for Schedules II through V (§ 5-304), and its instructions tell you to get it before you apply for your federal DEA registration. On the application you attest to 2 hours of continuing education (§ 5-301(c)). The U.S. Drug Enforcement Administration handles the federal side.
PDMP
Maryland PDMP Rules For Nurse Practitioners
Register with Maryland’s Prescription Drug Monitoring Program before anything else. Health-General § 21-2A-04.1 makes it a condition of a new or renewed CDS registration. Then § 21-2A-04.2 has you request at least the prior 4 months of a patient’s PDMP data before you start a course of treatment that includes an opioid or a benzodiazepine, repeat it at least every 90 days while that course continues, and document in the record that you requested and assessed it. The exceptions include a supply of 3 days or less, cancer or cancer-related pain, inpatient hospital and hospice patients, and up to 14 days of acute pain after surgery, a fracture, significant trauma or childbirth.
Next Step
Credentialing Is A Separate Track
None of this gets you paid on its own. Credentialing in Maryland is a separate track with its own payer rules, Medicaid program and enrollment timelines, and the Maryland 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.
Budgeting for the move? See what PMHNP credentialing costs and what it costs to start a PMHNP practice. If you’d rather hand us the setup, First Practice Launch covers a first practice’s payers, EHR, portals and billing for $6,000, or four monthly payments of $1,500.
FAQ
Frequently Asked Questions
Is Maryland A Full Practice Authority State For PMHNPs?
Yes. AANP classifies Maryland as full practice, and Health Occupations § 8-101(m) lets a nurse practitioner assess, diagnose, order tests and prescribe independently. Maryland dropped its physician attestation requirement on October 1, 2015, so there’s no collaborative agreement to file. A first-time NP still names a mentor for 18 months, and every NP practices under AANP standards or those of another certifying body the Board recognizes.
Do New Nurse Practitioners In Maryland Need A Mentor?
Only if you’ve never been certified as an NP by Maryland or another state’s board of nursing. You name the mentor on your certification application, and the 18 months run from the day the Board receives it. The mentor has to be a certified registered nurse practitioner or a licensed physician with at least 3 years of clinical practice experience (Health Occupations §§ 8-101(j) and 8-302.1(d)).
Can A PMHNP Prescribe Controlled Substances In Maryland?
Yes. You’ll need a Maryland Controlled Dangerous Substances registration from the Office of Controlled Substances Administration, then your federal DEA registration, in that order. Register with the Maryland PDMP first, because Health-General § 21-2A-04.1 makes PDMP registration a condition of a new or renewed CDS registration. The CDS application also asks you to attest to 2 hours of continuing education.
When Do Maryland Prescribers Have To Check The PDMP?
Before you start a course of treatment that includes an opioid or a benzodiazepine, request at least the prior 4 months of the patient’s data, repeat it at least every 90 days while that course continues, and document it in the record. Health-General § 21-2A-04.2 exempts supplies of 3 days or less, cancer treatment, inpatient and hospice patients, and up to 14 days of acute pain after surgery.
References
Official Maryland Sources
- Maryland Health Occupations § 8-101, definitions of NP practice and mentor, checked October 4, 2026.
- Maryland Health Occupations § 8-302.1, 18-month mentor for first-time NPs and AANP practice standards, checked October 4, 2026.
- 2015 Laws of Maryland, Chapter 468 (HB 999), repeal of the physician attestation, effective October 1, 2015, checked October 4, 2026.
- COMAR 10.27.07.03, nurse practitioner scope and standards of practice, checked October 4, 2026.
- COMAR 10.27.07.02, certification and the designated mentor, checked October 4, 2026.
- Maryland Criminal Law § 5-301, CDS registration and the 2-hour continuing education attestation, checked October 4, 2026.
- Office of Controlled Substances Administration practitioner instructions, Maryland CDS registration before DEA registration, checked October 4, 2026.
- Maryland Health-General § 21-2A-04.1, PDMP registration before a CDS registration, checked October 4, 2026.
- Maryland Health-General § 21-2A-04.2, when prescribers must request PDMP data, checked October 4, 2026.
This is general information, not legal advice. It applies the general nurse practitioner rules in Maryland to PMHNPs. Rules change, so check with the Maryland Board of Nursing and the AANP State Practice Environment map before you act on it. Last reviewed: September 26, 2026.
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