NP · District of Columbia
Collaborative Drug Therapy Management for Nurse Practitioners in District of Columbia
No. Nurse Practitioners here prescribe and adjust drug therapy on their own authority. District of Columbia does not require one.
HORA 2024 repealed D.C. Code § 3-1206.03's collaboration mandate — an NP may diagnose, treat, and prescribe under their own license with no supervising- or collaborating-physician relationship required, regardless of experience.
What the physician relationship must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
No proximity requirement
No physician availability/proximity standard applies — HORA 2024 removed the collaboration requirement entirely (D.C. Code Title 3, Ch. 12, Subch. VI).
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
Requires DEA registration and a separate DC controlled-substance registration. Some secondary sources state that NPs may not issue refillable prescriptions for controlled substances; that limit is not confirmed in primary DC regulation.
Written agreement
Not required
Unconditional as of HORA 2024 (2024) — a physician relationship may still be privately negotiated (e.g. a referral arrangement or medical-director role), but DC law no longer requires one as a condition of NP practice.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Board of Nursing licensure; the § 29-508 physician-only PC/PLLC regime does not apply, and no statute sets out an NP practice-entity ownership pathway
Distinct from the clinical independence granted by HORA 2024 above — entity ownership and clinical practice authority are separate legal questions.
Sources for the supervision rules (3)
- D.C. Code § 3-1206.03 [Repealed by the Health Occupations Revision Amendment Act of 2024 (D.C. Law 25-191 / B25-0545)]
- D.C. Code § 3-1206.07a — Certified Nurse Practitioner scope of practice
- D.C. Code § 3-1201.02 — Definitions of health occupations
What a collaborating physician costs here
Typical monthly cost in District of Columbia
$500 – $600
Estimate for one Nurse Practitioner. Standard-tier state.
About District of Columbia's rules
The Health Occupations Revision Amendment Act of 2024 repealed D.C. Code § 3-1206.03, removing the collaboration mandate for every APRN category (NP, PMHNP, CRNA, CNM, CNS); DC is now a full-practice-authority jurisdiction for APRNs. PAs are not covered by that reform and still need a Board of Medicine Delegation Agreement regardless of experience.
Other clinicians in District of Columbia: see the state overview.