Nurse Practitioner Cheat Sheet for Maryland

Requirements for Supervising Physician agreements in Maryland, plus a free agreement builder tailored to Maryland law.

Provider supervision requirements in Maryland

Updated 2026-09-03

Provided for educational and research purposes only — this is not legal advice. Laws and regulations change frequently, and this content may contain errors or omissions. Always confirm current requirements with a licensed attorney before relying on this for compliance decisions.

Maryland's APRN categories are not uniform: CRNPs and CNMs gained full practice authority in 2015 (after an 18-month new-graduate mentorship), CRNAs remain fully supervised with no prescriptive authority at all (Maryland is one of about 11 states granting CRNAs none), and only the psychiatric-mental-health population focus of CNS practice is independent. Maryland does not recognize PLLCs; professional entities use physician-only professional corporations, so multi-disciplinary ownership questions remain open.

Nurse Practitioner

Independent practice requires: 18 months of mentorship (available consultation/collaboration) from a Maryland-licensed physician or NP with ≥3 years' clinical experience — ONLY required for an NP never previously certified in Maryland or any other state; an NP already certified elsewhere is exempt from this mentorship entirely and practices independently from initial MD certification

Conditional independence

The 2015 Nurse Practitioner Full Practice Authority Act eliminated the prior mandatory physician-attestation/collaboration requirement. The mentorship is informal (no written agreement filed) and time-bound, not indefinite — after 18 months (or immediately, if already certified elsewhere) the NP practices fully independently.


Proximity

  • first-time NP (never certified in any state) during the 18-month mentorship: Available remotely (no on-site requirement)

    The mentor need only be 'available for advice, consultation, and collaboration, as needed' — no on-site or fixed-radius standard.
  • after the 18-month mentorship, or any NP already certified in another state: No proximity requirement

    No physician availability/proximity standard applies once independent.

Chart review

Not codified — left to the practice agreement

Prescriptive authority

Covered by practice agreement · controlled substances permitted

Schedule II-V. Schedule II-III prescriptions are capped at a 30-day supply per single filling under Maryland's general controlled-substance dispensing limits. Requires Maryland CDS registration and federal DEA registration.

Practice ownership (CPOM)

Licensee-only ownership required — Physician-only professional corporations; Maryland does not recognize PLLCs, and no statute sets out an NP practice-entity ownership pathway

This ownership question is legally distinct from the clinical independence granted by the 2015 Act above.

Supervision ratio

Not codified — left to the practice agreement

Meeting cadence

Not codified — left to the practice agreement

Written agreement

Not required

No written collaborative practice agreement is required at any point — even the 18-month first-time-NP mentorship is an informal consultation relationship, not a filed agreement.

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Estimated NP supervision cost in Maryland

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Available Supervising Physicians in Maryland

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