[hen-ui-dynamic-experience placement=”aboveTheFold” /][hen-ui-card variant=”background-white” border=”stroke”][hen-ui-flex direction=”column” gap=”lg”][hen-ui-heading variant=”h2″]Key Takeaways[/hen-ui-heading][hen-ui-list variant=”unordered” bullet-style=”check” marker-color=”secondary”] [hen-ui-list-item][hen-ui-text variant=”b4″]States grant NP practice authority at three levels – full, reduced, or restricted – defining the ability for NPs to diagnose, prescribe, and operate their own practice independently.[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]30 US states/territories allow full practice, 15 have reduced autonomy, and 11 require physician supervision under restricted practice authority.[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]There has been a push to further expand NP practice authority, as this could increase accessibility to healthcare providers who can diagnose and treat health conditions.[/hen-ui-text][/hen-ui-list-item][/hen-ui-list][/hen-ui-flex][/hen-ui-card][hen-ui-text variant=”b4″]In many states, the laws establishing nurse practitioner (NP) roles are in flux. This guide defines a nurse practitioner’s scope of practice, explains the three levels of practice authority, and lists states by practice authority. Read on to understand how practice authority can affect your career as a nurse practitioner.[/hen-ui-text][hen-ui-flex gap=”xl” align=”left” direction=”column”][hen-ui-flex gap=”xs” align=”left” direction=”column”][hen-ui-heading variant=”h2″]Popular Online Nursing Programs[/hen-ui-heading][hen-ui-text variant=”b4″ color=”subtext”]Learn about start dates, transferring credits, availability of financial aid, and more by contacting the universities below.[/hen-ui-text][/hen-ui-flex][hen-ui-dynamic-experience placement=”belowTheFold” /][/hen-ui-flex][hen-ui-heading variant=”h2″]What is Scope of Practice?[/hen-ui-heading][hen-ui-text variant=”b4″]Scope of practice refers to the professional activities that each state authorizes nurses or other clinical staff to perform. An NP’s scope of practice can include assessing a patient’s condition, ordering tests, interpreting results and making diagnoses, [hen-ui-link href=”/nurse-practitioner/can-nurse-practitioners-prescribe-medication/”]prescribing medication[/hen-ui-link], and ordering treatments.[/hen-ui-text][hen-ui-text variant=”b4″]Scope of practice varies by state. In some states, NPs must work under a physician’s supervision or in collaboration with a physician, while other [hen-ui-link href=”https://nursejournal.org/articles/best-states-to-work-as-a-nurse-practitioner/”]states allow nurse practitioners[/hen-ui-link] to practice independently.[/hen-ui-text][hen-ui-heading variant=”h2″]How Scope of Practice Relates to Practice Authority[/hen-ui-heading][hen-ui-text variant=”b4″]Scope of practice falls into three main categories, or levels, of practice authority: full, reduced, or restricted practice authority.[/hen-ui-text][hen-ui-card variant=”background-secondary” border=”strokeLight” rounded=”lg” padding=”lg”] [hen-ui-card-content] [hen-ui-heading variant=”h3″ class=”text-white”]Full Practice[/hen-ui-heading][hen-ui-text variant=”b4″ class=”text-white”]In full practice authority states, nurse practitioners can perform the full scope of practice without a supervising or collaborating physician. They can diagnose a patient, order tests, prescribe medication, and operate their own independent practices. Nurse practitioner independent practice states may require a certain level of experience working under a physician’s supervision or require additional training before allowing full practice authority. Because these requirements are not permanent, these states are still considered full practice authority states.[/hen-ui-text] [/hen-ui-card-content][/hen-ui-card][hen-ui-card variant=”background-secondary” border=”strokeLight” rounded=”lg” padding=”lg”] [hen-ui-card-content] [hen-ui-heading variant=”h3″ class=”text-white”]Reduced Practice[/hen-ui-heading][hen-ui-text variant=”b4″ class=”text-white”]In reduced practice states, nurse practitioners can perform some of their scope of practice without physician supervision. These restrictions typically involve operating their own practices or prescribing certain types of medications. They rarely involve the nurse practitioner’s ability to order tests or diagnose conditions. For example, a nurse practitioner might need to be part of a practice that is supervised by a physician, rather than running their own practice, but within that practice, can operate with relative autonomy.[/hen-ui-text] [/hen-ui-card-content][/hen-ui-card][hen-ui-card variant=”background-secondary” border=”strokeLight” rounded=”lg” padding=”lg”] [hen-ui-card-content] [hen-ui-heading variant=”h3″ class=”text-white”]Restricted Practice[/hen-ui-heading][hen-ui-text variant=”b4″ class=”text-white”]In restricted practice states, nurse practitioners must work under the supervision of a physician for all of their scope of practice. While they may have extensive autonomy in some nurse practitioner functions, they are not acting as independent practitioners. However, some states may loosen restrictions as the NP gains experience.[/hen-ui-text] [/hen-ui-card-content][/hen-ui-card][hen-ui-heading variant=”h3″]State-by-State NP Practice Authority[/hen-ui-heading][hen-ui-heading variant=”h2″]States by Nurse Practitioner Practice Authority[/hen-ui-heading][hen-ui-text variant=”b4″]Each state establishes its own NP practice authority regulations. This list provides the latest nurse practitioner scope of practice by state or territory.[/hen-ui-text][hen-ui-card variant=”background-white” border=”stroke” padding=”lg”] [hen-ui-card-content] [hen-ui-heading variant=”h3″]Full Practice Authority States/Territories[/hen-ui-heading] [hen-ui-grid columns-md=”2″ gap=”sm”] [/hen-ui-grid] [/hen-ui-card-content][/hen-ui-card][hen-ui-card variant=”background-white” border=”stroke” padding=”lg”] [hen-ui-card-content] [hen-ui-heading variant=”h3″]Reduced Practice Authority States[/hen-ui-heading] [hen-ui-grid columns-md=”2″ gap=”sm”] [/hen-ui-grid] [/hen-ui-card-content][/hen-ui-card][hen-ui-card variant=”background-white” border=”stroke” padding=”lg”] [hen-ui-card-content] [hen-ui-heading variant=”h3″]Restricted Practice Authority States[/hen-ui-heading] [hen-ui-grid columns-md=”2″ gap=”sm”] [/hen-ui-grid] [/hen-ui-card-content][/hen-ui-card][hen-ui-heading variant=”h2″]The Push for Full Practice Authority[/hen-ui-heading][hen-ui-text variant=”b4″]Expanding NP practice authority produces many benefits for healthcare consumers. It increases the availability of healthcare providers who can diagnose and treat health conditions; expands the availability of family practitioners during current and projected shortages; and because nurse practitioner salaries are lower than physician salaries, provides care at a lower cost.[/hen-ui-text][hen-ui-text variant=”b4″]However, many individuals and organizations, especially physician organizations, express concerns that many conditions that should be diagnosed and treated only by physicians are instead being treated by NPs and that healthcare payers, especially insurance companies, may pressure healthcare providers to use NPs instead of physicians. This, they argue, can result in a lower quality of care and outcomes for patients with complex or serious health conditions.[/hen-ui-text][hen-ui-text variant=”b4″]Physicians also earn more from supervising NPs and would lose out on this revenue source if [hen-ui-link href=”/articles/states-where-nurse-practitioners-can-open-their-own-practices/”]NPs practice independently[/hen-ui-link]. Given the rapid growth in full practice authority states, it seems that state legislators believe in the positive impact of expanding NP practice authority.[/hen-ui-text][hen-ui-text variant=”b4″]Learn how you can get involved in the push for NP full-practice authority with [hen-ui-link href=”/resources//nurse-practitioner-fpa-toolkit/”]our advocacy guide[/hen-ui-link].[/hen-ui-text][hen-ui-heading variant=”h2″]Frequently Asked Questions About Nurse Practitioner Practice Authority[/hen-ui-heading][hen-ui-accordion variant=”no-background”] [hen-ui-accordion-item title=”How does nurse practitioner authority vary by state?” expanded=”true”] [hen-ui-text variant=”b4″]Each state establishes the laws that govern nursing scope of practice. In full practice authority states, NPs can establish independent practices. In other states, NPs may need to work under a physician or with a physician, though they otherwise can diagnose and treat patients without limitations. Other states limit certain NP functions, such as prescribing medications.[/hen-ui-text] [/hen-ui-accordion-item] [hen-ui-accordion-item title=”In what states can an NP practice independently?”] [hen-ui-text variant=”b4″]Currently, nurse practitioners have full practice authority in 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, Washington, D.C., and Wyoming. However, this list is likely to grow as more states consider legislation to expand NP authority.[/hen-ui-text] [/hen-ui-accordion-item] [hen-ui-accordion-item title=”Are NPs licensed by state?”] [hen-ui-text variant=”b4″]All nurses, including NPs, are licensed by the state in which they practice or by a multi-state license. State boards of nursing establish the criteria for becoming licensed. These criteria include graduating from an accredited program and passing a certification examination, as well as maintaining licensing through continuing education.[/hen-ui-text] [/hen-ui-accordion-item] [hen-ui-accordion-item title=”Where are NPs able to practice independently?”] [hen-ui-text variant=”b4″]Currently, NPs can now practice independently in 28 states/territories and in Washington, D.C. In other states, while NPs may perform many of their job functions with a high level of independence, they must work in collaboration with or under the supervision of a physician.[/hen-ui-text] [/hen-ui-accordion-item][/hen-ui-accordion]