PMHNP Scope And Prescribing Rules In Pennsylvania

Practice Authority

What Is Pennsylvania NP Practice Authority?

Pennsylvania licenses nurse practitioners as certified registered nurse practitioners (CRNPs) and requires them to practice in collaboration with a physician. AANP’s State Practice Environment map puts Pennsylvania among the states that require a career long collaborative arrangement rather than full independent practice. PMHNPs are no exception. They practice as CRNPs within their psychiatric-mental health specialty.

The Pennsylvania State Board of Nursing, part of the Department of State, administers the CRNP rules, and the exact requirements for collaboration and prescriptive authority are set by regulation.

Collaboration & Agreements

Is A Physician Agreement Required In Pennsylvania?

Yes. To prescribe, you need a prescriptive authority collaborative agreement, and 49 Pa. Code § 21.285(a) spells out what goes in it. Your agreement has to:

• be in writing, signed and dated, and name you, your collaborating physician and at least one substitute physician who covers when your collaborating physician isn’t available
• name the specialty you’re certified in
• list the categories of drugs you can prescribe or dispense
• say when and how often your collaborating physician will personally see the patient
• be kept at your primary practice location, with a copy filed with the Bureau of Professional and Occupational Affairs
• be available to anyone who asks for it, and free to any pharmacist who requests it
• be reviewed and updated by you and your physician at least once every 2 years, or whenever it changes
• state the amount of professional liability insurance that covers you

You notify the Board in writing when the agreement is updated or terminated (§ 21.285(b)). Section 8.3 of the Professional Nursing Law sets the statutory floor, which is your specialty, your drug categories and how often the physician will personally see the patient.

Physician Limit

How Many CRNPs Can One Physician Collaborate With In Pennsylvania?

Pennsylvania doesn’t set a number. The old § 21.287 barred a physician from supervising more than four prescribing CRNPs at once. The State Board of Nursing deleted it in its December 2009 rulemaking (39 Pa.B. 6994), calling it outdated and contrary to the collaboration model the legislature adopted in December 2002, and § 21.287 now reads [Reserved]. A health care facility can still set its own oversight rules for the clinicians who practice there (Professional Nursing Law § 8.2(c.2)).

Prescribing

Prescriptive Authority And Controlled Substances

Your prescribing runs through the prescriptive authority collaborative agreement, and 49 Pa. Code § 21.284 sets the limits. You can write a Schedule II prescription for up to a 30-day supply and a Schedule III or IV prescription for up to a 90-day supply, as your agreement identifies, and you can’t prescribe Schedule I drugs.

You’ll need your own DEA registration (§ 21.284b). If you prescribe controlled substances, § 21.283(b)(4) also calls for 2 hours of education in pain management or identifying addiction and 2 hours on prescribing or dispensing opioids within a year of getting prescriptive authority.

Chart Review

Does Pennsylvania Require Chart Review For CRNPs?

Chart review is part of how the regulations define collaboration, but there’s no quota. The definition in 49 Pa. Code § 21.251 includes a physician available on a regularly scheduled basis for referrals and for review of the standards of medical practice, incorporating consultation and chart review, plus co-signing records when necessary to document accountability.

It doesn’t set a number or percentage of charts. What your agreement does have to state is when and how often your collaborating physician will personally see the patient (§ 21.285(a)(4)).

PDMP

Pennsylvania PDMP Rules For CRNPs

The Department of Health requires every prescriber licensed in Pennsylvania to register with the PDMP. You query it each time you prescribe a patient an opioid or a benzodiazepine, the first time you prescribe that patient any controlled substance, and whenever you have reason to believe a patient is misusing or diverting drugs. Those rules come from the ABC-MAP Act (Act 191 of 2014, amended by Act 124 of 2016).

Next Step

Credentialing Is A Separate Track

Practice authority decides what you can do in Pennsylvania. It doesn’t get you paid. Payer enrollment runs on its own track, and our Pennsylvania credentialing and payer enrollment guide covers it. The PMHNP credentialing guide has the national picture.

On Headway, Alma, Grow or Rula today? You can usually keep seeing clients there while we build contracts in your own practice, and this page explains how.

Planning the sequence? Our guide on how to start a PMHNP practice and the practice launch checklist put licensure, any collaboration your state requires and enrollment in order. See what PMHNP credentialing costs and what it costs to start a PMHNP practice before you budget, and browse the PMHNP hub for the rest.

FAQ

Pennsylvania PMHNP: Frequently Asked Questions

References

Official Pennsylvania Sources

• 49 Pa. Code § 21.251, definition of collaboration, including chart review, checked October 25, 2026.
• 49 Pa. Code § 21.282a, CRNP practice in collaboration with a physician, checked October 25, 2026.
• 49 Pa. Code § 21.283, prescriptive authority and opioid education, checked October 25, 2026.
• 49 Pa. Code § 21.284, drug categories and Schedule II to IV supply limits, checked October 25, 2026.
• 49 Pa. Code § 21.284b, DEA registration and controlled substance standards, checked October 25, 2026.
• 49 Pa. Code § 21.285, prescriptive authority collaborative agreement contents, checked October 25, 2026.
• 39 Pa.B. 6994 (December 12, 2009), deletion of the four-CRNP limit in § 21.287, checked October 25, 2026.
• Professional Nursing Law, sections 8.2 and 8.3, collaboration and the written agreement minimums, checked October 25, 2026.
• Pennsylvania Department of Health, PDMP prescriber requirements, registration and query rules, checked October 25, 2026.
• Senate Bill 25 of 2025, status, referred to committee January 22, 2025, checked October 25, 2026.
• House Bill 739 of 2025, status, referred to committee February 26, 2025, checked October 25, 2026.