PMHNP practice requirements by state

Nurse practitioner practice authority in all 50 states and D.C.

States fall into three groups. Full practice: NPs can evaluate, diagnose, treat and prescribe without a physician agreement, sometimes after a transition period. Reduced practice: a collaborative agreement is required for at least one part of practice. Restricted practice: supervision, delegation or team management is required.

* State notes: Connecticut: Connecticut requires new APRNs to practice in collaboration with a Connecticut-licensed physician for their first three years before practicing independently. Georgia: Georgia requires a nurse protocol agreement with a delegating physician who practices in a comparable specialty. Georgia expanded what physicians can delegate to APRNs in 2024, so confirm current prescribing rules with the Georgia Composite Medical Board. New Jersey: New Jersey passed a law in March 2026 removing the joint protocol requirement for qualified advanced practice nurses. The AANP May 2026 map still lists New Jersey as reduced practice, so check the New Jersey Board of Nursing for when and how the change applies to you. Vermont: Vermont requires a collaborative provider until you have 2,400 hours and 24 months of practice in your specialty.

Full practice (27 states plus D.C.): Alaska, Arizona, Colorado, Connecticut, Delaware, Hawaii, Idaho, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington, Wyoming.

Reduced practice (12 states): Alabama, Arkansas, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Jersey, Ohio, Pennsylvania, West Virginia, Wisconsin.

Restricted practice (11 states): California, Florida, Georgia, Michigan, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia.

Practicing in more than one state

For telehealth, the state where the patient is located sets the rules. Each added state needs its own APRN license, DEA registration if you prescribe controlled substances, a collaborative agreement if that state requires one, and credentialing with that state's insurance plans. The APRN Compact, which would allow a multistate NP license, is not in effect yet. Our guide to starting a PMHNP private practice covers multi-state practice step by step, and the PMHNP credentialing guide explains payer enrollment.

Sources and updates

Practice categories follow the AANP 2026 State Practice Environment map (updated May 2026). Board of nursing links were checked on October 10, 2026. State laws change often, and some states set additional rules for new NPs, prescribing or telehealth. This tool is general information, not legal advice; confirm current requirements with the state board of nursing before you apply, sign an agreement or see patients.