NP · Michigan
Collaborative Drug Therapy Management for Nurse Practitioners in Michigan
Yes, a written agreement with a physician is required before you prescribe and adjust drug therapy. Michigan calls it a Delegation Agreement.
Michigan is not a full-practice-authority state — NP specialty certification alone does not grant autonomous practice (MCL 333.17201). NPs perform clinical acts, tasks, and functions DELEGATED by a physician under a written authorization; there is no experience-based pathway out of that delegation relationship.
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
Available remotely (no on-site requirement)
Michigan does not impose a geographic proximity requirement — the physician must be continuously available by telecommunications for consultation but need not be physically co-located with the NP.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Annually
The delegating physician must review and update the written authorization/collaborative practice agreement on an annual basis after the original or amended date; the agreement itself must provide for 'systematic formal planning and evaluation meetings' between physician and NP, with no fixed interim cadence codified beyond that annual review.
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
A physician may delegate prescribing of Schedule II-V controlled substances to an NP (excluding nurse anesthetists) via a written authorization kept at the primary practice site, with a signed copy given to the NP and reviewed/updated at least annually (Mich. Admin. Code R 338.2411). Requires the NP's own DEA registration.
Written agreement
Required
Unconditional — a written delegation/collaborative practice agreement with a physician is required for as long as the NP practices; the delegating physician must review and update it at least annually (Mich. Admin. Code R 338.2411).
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — No statute sets out an NP practice-entity ownership pathway; Michigan generally prohibits nonphysician-owned entities from practicing medicine
This ownership question is legally distinct from the clinical delegation agreement above.
Sources for the supervision rules (3)
What a collaborating physician costs here
Typical monthly cost in Michigan
$500 – $700
Estimate for one Nurse Practitioner. This state's proximity rules add a small premium.
About Michigan's rules
Michigan has no independent-practice pathway for NPs, CNMs, CNSs, or PAs — specialty certification alone never grants autonomous practice, and delegated authority is renewable/revocable rather than a one-time threshold. CRNAs may deliver anesthesia care independently within the perioperative period but must still maintain a collaborating physician/dentist/podiatrist relationship. A PA-only PLLC has been prohibited since 2010.
Other clinicians in Michigan: see the state overview.