Practice Protocol
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Protocol · NP · Oklahoma

Practice Protocol for Nurse Practitioners in Oklahoma

Required. Oklahoma law names the instrument a Supervision, Collaboration, and Referral Plan, and the clinical protocol is the content that instrument carries. Below: the board that governs it, what it must contain, and the terms it has to carry.

Practice authorityConditional independence
Written agreementAgreement required
What Oklahoma calls itSupervision, Collaboration, and Referral Plan
Governing boardOklahoma Board of Nursing and the Oklahoma State Board of Pharmacy
Agreement familyCollaborative Practice
Research date2026-09-03 · clauses 2026-09-03

Before H.B. 2298, Oklahoma required physician supervision for NP prescriptive authority indefinitely (a AANP 'restricted practice' state). Non-prescribing NP practice itself did not require supervision even pre-reform; the supervision requirement has always attached specifically to prescribing.

Independent practice requires: ≥6,240 hours of supervised clinical practice, then Board of Nursing approval of independent prescriptive authority (H.B. 2298, eff. Nov. 1, 2025).

What an Oklahoma Supervision, Collaboration, and Referral Plan must contain

Governed by the Oklahoma Board of Nursing and the Oklahoma State Board of Pharmacy. Each numbered item is a statutory requirement the Supervision, Collaboration, and Referral Plan must satisfy.

  1. Unless the Nurse Practitioner has completed six thousand two hundred forty (6,240) hours of supervised clinical practice that included prescribing and been approved by the Oklahoma Board of Nursing for independent prescriptive authority under 59 O.S. §§ 567.3a, 567.4a, and 567.4c, the Nurse Practitioner shall practice under a written Supervision, Collaboration, and Referral Plan with the Physician. If the Nurse Practitioner holds independent prescriptive authority, the Nurse Practitioner shall maintain professional liability insurance of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) annually, and shall include "Independent Rx Authority" on each prescription in lieu of a supervising physician's name.

  2. The Plan shall set out the referral, consultation, and collaboration procedures between the Parties and the method by which the Physician will be available, whether directly or by telecommunication, and shall identify each supervising physician's active DEA and Oklahoma Bureau of Narcotics and Dangerous Drugs registration. A physician may not supervise more than six (6) Nurse Practitioners and Physician Assistants combined for prescriptive-authority purposes, absent a Board-approved exception.

  3. The Supervision, Collaboration, and Referral Plan also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.

Terms it has to carry

Ratio, proximity, chart review, meeting and prescribing terms the Supervision, Collaboration, and Referral Plan has to carry, from Oklahoma's supervision rules.

Proximity

below the 6,240-hour independent-prescriptive-authority threshold: Available remotely (no on-site requirement)

No geographic/proximity requirement; the supervising physician need not be located in Oklahoma. Must be 'continuously available' for consultation via direct contact, telecommunications, or other electronic means.

after Board approval of independent prescriptive authority: No proximity requirement

No ongoing proximity/availability requirement; prescriptions are marked 'Independent Rx Authority' rather than carrying a supervising physician's name.

Supervision ratio

below the 6,240-hour independent-prescriptive-authority threshold: Up to 6 at a time (combined across provider types)

Same combined 6-PA/NP cap under OAC 435:10-13-2 as the `pa` entry above — see that entry's note on the unresolved post-reform conflict in secondary sources about whether this cap still applies.

Chart review

Not codified — left to the agreement

Meeting cadence

Not codified — left to the agreement

Prescriptive authority

Separate prescribing terms required · controlled substances permitted

Schedule I and II excluded by statutory exclusionary formulary (63 O.S. § 2-312(C)); Schedule III–V limited to a 30-day supply. Requires 45 contact hours of Category B CE (or 3 credit hours Category A) in pharmacotherapeutics within 3 years initially, then 15 hours (or 1 credit) per 2-year renewal; federal DEA and OBNDD registration required; electronic prescribing (EPCS) is mandatory for all controlled substances.

Written agreement

Required

Required only for prescriptive authority below the 6,240-hour threshold — non-prescribing NP practice does not require a supervision agreement at any experience level, and an NP who clears the threshold and is Board-approved needs no ongoing agreement.

Practice ownership (corporate practice of medicine)

Non-licensee ownership permitted — Same as the general CPOM note above — Oklahoma has no CPOM doctrine; an NP may independently own a clinical entity.

Sources for the supervision rules (5)
How the relationship works day to day
Who has to be where, how often you meet, and what the physician costs: Nurse Practitioner in Oklahoma on collaborativeagreement.com.

About Oklahoma's rules

HB 2298 (APRNs) and HB 2584 (PAs), both 2025 and effective Nov. 1, 2025, created new hours-based independent-practice pathways in a state with no prior pathway for either. Being this recent, secondary sources conflict on whether a 6-provider physician-ratio cap (OAC 435:10-13-2) still applies post-reform — flagged per-provider below rather than guessed. Oklahoma has no corporate-practice-of-medicine doctrine (Okla. A.G. Op. 77-168).

Other clinicians in Oklahoma: see the state overview.