Page 11 - Part 2 Collaborating with Advanced Practice Providers - An Overview of State Rules

SVMIC Collaborating with Advanced Practice Providers

Supervising or Collaborating Limits per State

Is there a limit on the number of nurse practitioners and/or

physician assistants that a physician can collaborate with or

supervise? The number or ratio of APPs to supervising and/or

collaborating physicians varies by state. See below for specific state

limitations in the SVMIC coverage area. Where silent, many states
suggest the American Medical Association’s general guideline that

appropriate supervision should be determined by physicians at the

practice level, consistent with good medical practice and state law

where relevant. Note that for the states with defined limits, the range is

from two (2) to eight (8) APPs. If a provider currently or later intends to
enter into a supervisory or collaborative relationship with a number of

APPs, in addition to the state rules, there are other risk management

considerations including availability to mentor, consult, review and

document efforts.

Alabama

The physician may not enter into collaborative agreements that exceed

a cumulative 160 hours (four full-time equivalents) per week (including
any combination of CRNPs, midwives or PAs.) unless an exemption is

granted.
5

Arkansas

There is no defined limit.

5 Ala. Admin. Code r. 540-X-7-.26(2).

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