Clinical Nurse Specialist Cheat Sheet for Pennsylvania
Requirements for Supervising Physician agreements in Pennsylvania, plus a free agreement builder tailored to Pennsylvania law.
Provider supervision requirements in Pennsylvania
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.
Pennsylvania has no independent-practice pathway for CRNPs — SB 25-style full-practice-authority bills have been introduced every session without passing. PA (physician assistant) reform via Acts 78/79 of 2021 removed prior Board pre-approval of written agreements and the flat 100%-countersignature rule after the first year, but a written agreement and supervision remain mandatory. PA is a CPOM state: only licensed physicians may own a medical professional corporation.
Clinical Nurse Specialist
49 Pa. Code Chapter 21, Subchapter H governs CNS practice but limits it to acts already within the scope of professional nursing; it does not add CNS-specific collaborative-agreement or supervision detail. Confirm with the State Board of Nursing before relying on this entry.
Proximity
Not codified — left to the practice agreement
Chart review
Not codified — left to the practice agreement
Prescriptive authority
Covered by practice agreement · no controlled-substance authority
Pennsylvania's rules do not clearly address CNS prescriptive authority; treat it as uncertain rather than a confirmed absence.Practice ownership (CPOM)
Licensee-only ownership required — Same physician and licensee-only ownership regime as PAs and NPs; no CNS-specific provision
Supervision ratio
Not codified — left to the practice agreement
Meeting cadence
Not codified — left to the practice agreement
Written agreement
Not required
Shown as not required, though not affirmatively settled: secondary sources note that only 11 states require a CNS collaborative-practice agreement and do not clearly place Pennsylvania in that group. Check Subchapter H's text.$500–$700/mo
Estimated CNS supervision cost in Pennsylvania
Available Supervising Physicians in Pennsylvania
Browse supervising physicians open to new collaborations near you.