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Pennsylvania

PMHNP Practice Requirements In Pennsylvania: Scope, Prescribing & Collaboration

Pennsylvania licenses a PMHNP as a certified registered nurse practitioner (CRNP) who practices in collaboration with a physician for the whole career, and to prescribe you need a written prescriptive authority collaborative agreement naming your collaborating physician and at least one substitute physician (49 Pa. Code § 21.285). No rule caps how many CRNPs one physician can collaborate with, Schedule II prescriptions are limited to a 30-day supply and Schedule III or IV to 90 days, and chart review is part of collaboration without a set number of charts.

At A GlancePennsylvania
Practice AuthorityCollaboration with a physician for your whole career (49 Pa. Code § 21.282a).
Physician AgreementWritten prescriptive authority collaborative agreement naming a collaborating physician and at least one substitute, reviewed at least every 2 years (§ 21.285).
Physician LimitNo cap. The four-CRNP limit in § 21.287 was deleted in 2009 (39 Pa.B. 6994).
Controlled SubstancesSchedule II up to a 30-day supply, Schedule III or IV up to 90 days, no Schedule I (§ 21.284).
Chart ReviewPart of collaboration as § 21.251 defines it, with no set number or percentage.
PDMPQuery each time you prescribe an opioid or benzodiazepine, and the first time you prescribe a patient any controlled substance.
Transition To PracticeNone. Experience doesn’t end the collaboration requirement.
RegulatorPennsylvania State Board of Nursing.

Updated September 26, 2026

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.

Category

A collaborative-agreement state per the AANP map. AANP updates the AANP State Practice Environment page as state laws are amended.

CRNP Licensure

Pennsylvania NPs are certified as CRNPs in a specialty and practice in collaboration with a physician.

Population Focus

As a PMHNP, you practice within your psychiatric-mental health certification and the terms of your collaborative agreement.

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, with its own payer rules, Medicaid program and timelines, and our Pennsylvania 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 walks through licensure, collaboration and enrollment in sequence. The PMHNP hub has the rest of our billing, credentialing and operations guides.

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

Pennsylvania PMHNP: Frequently Asked Questions

Can A PMHNP Practice Independently In Pennsylvania?

No. Section 8.2 of the Professional Nursing Law and 49 Pa. Code § 21.282a have a CRNP diagnose and treat in collaboration with a physician for the whole career, and prescribing runs through a written prescriptive authority collaborative agreement. The bills that would change that, Senate Bill 25 and House Bill 739, were still in committee when we checked on October 4, 2026.

How Many CRNPs Can A Collaborating Physician Have In Pennsylvania?

Pennsylvania’s rules don’t set a limit. The old cap of four prescribing CRNPs per physician in 49 Pa. Code § 21.287 was deleted in December 2009 (39 Pa.B. 6994), and the section is now reserved. Your agreement still has to name at least one substitute physician besides your collaborating physician, and a health care facility can set its own oversight rules.

Can Pennsylvania PMHNPs Prescribe Controlled Substances?

Yes, within your agreement. Under 49 Pa. Code § 21.284 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, but no Schedule I drugs. You’ll need your own DEA registration, and you query the PDMP each time you prescribe an opioid or a benzodiazepine.

What Has To Be In A Pennsylvania Collaborative Agreement?

Under 49 Pa. Code § 21.285 it’s written, signed and dated, and it names you, your collaborating physician and at least one substitute physician. It lists your specialty, the drug categories you can prescribe, how often the physician will personally see patients and your professional liability coverage. You keep it at your primary practice location, file a copy with the state and update it at least every 2 years.

Does Pennsylvania Require Chart Review For CRNPs?

Chart review is part of how 49 Pa. Code § 21.251 defines collaboration, along with consultation and co-signing records when necessary, but the definition doesn’t set a number or percentage of charts. Your agreement has to state when and how often the collaborating physician will personally see the patient, so that’s the commitment you and the physician put in writing.

References

Official Pennsylvania Sources

This is general information, not legal advice. Rules change, so check with the Pennsylvania State Board of Nursing before you act on it. Last reviewed: September 26, 2026.

Neighboring States

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