Protocol · NP · Maryland
Practice Protocol for Nurse Practitioners in Maryland
Maryland does not define a named protocol for Nurse Practitioners. Here is what the state does require and what a written protocol usually covers.
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.
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.
What a Nurse Practitioner protocol covers in Maryland
Not every Nurse Practitioner in Maryland needs one; the conditions are under "Written agreement" below. When one is required, these are its clauses. The Maryland Board of Nursing and the Maryland Board of Pharmacy governs nurse practitioners here.
Maryland does not require the Nurse Practitioner to enter into a collaborating-physician agreement or attestation; the Nurse Practitioner practices, diagnoses, and prescribes, including Schedule II through V controlled substances, under the Nurse Practitioner's own license, consistent with Health Occupations Article, Title 8, and shall separately hold a Maryland Controlled Dangerous Substances (CDS) registration if prescribing controlled substances.
If this is the Nurse Practitioner's first certification as a Certified Registered Nurse Practitioner in any state, the Nurse Practitioner shall identify a mentor — a Certified Registered Nurse Practitioner or physician with at least three (3) years of clinical experience — for eighteen (18) months of consultation and collaboration from the date the Nurse Practitioner's certification application is received by the Maryland Board of Nursing.
- A voluntary protocol also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
Maryland's supervision rules
Ratio, proximity, chart review, meeting and prescribing rules for nurse practitioners, and the conditions under which a written protocol becomes required.
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.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified
Meeting cadence
Not codified
Prescriptive authority
No agreement needed to prescribe · 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.
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.
Practice ownership (corporate practice of medicine)
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.
About Maryland's rules
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.
Other clinicians in Maryland: see the state overview.