NP · South Dakota
Collaborative Drug Therapy Management for Nurse Practitioners in South Dakota
Yes, a written agreement with a physician is required before you prescribe and adjust drug therapy. South Dakota calls it a Written Collaborative Agreement.
Once the 1,040-hour threshold is met, no ongoing agreement of any kind is required — SDCL 36-9A-13.1 only imposes a general duty to 'collaborate' (communicate/consult/refer as appropriate), not a document or physician-specific gate. SD has used this model since a 2017 reform (SL 2017, ch 171).
Independent practice requires: ≥1,040 practice hours as a licensed CNP (or CNM); until then, a written collaborative agreement with a physician OR an already-independent CNP/CNM (SDCL 36-9A-4(5)) — the collaborator need not be a physician.
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
Not codified — left to the agreement
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
SDCL 36-9A-12(4)(b): may prescribe, administer or furnish 'over-the-counter, legend, and controlled drugs or substances listed on Schedule II in chapter 34-20B.' The statute's plain text names only Schedule II, while the Board of Nursing's own CNP practice guidance describes broader controlled-substance authority; confirm with the Board whether Schedule III–V are covered by the same clause or by board rule before relying on this for a Schedule III–V prescription.
Written agreement
Required
Only pre-1,040-hour NPs need the written collaborative agreement (SDCL 36-9A-4(5)); once that threshold is met, agreementRequired is effectively False — see conditions above.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — South Dakota's professional-corporation statute for nursing services should be checked; not settled
What a collaborating physician costs here
Typical monthly cost in South Dakota
$500 – $600
Estimate for one Nurse Practitioner. Standard-tier state.
About South Dakota's rules
SD is unusually permissive: NP/CNM need only 1,040 practice hours (or a collaborative agreement with ANY physician OR already-independent NP/CNM) to become fully independent (SDCL 36-9A), and a 2025 reform (SL 2025, ch 149) gives PAs the same kind of pathway after 6,000 hours plus NCCPA certification. Older sources citing a fixed PA-per-physician ratio are now outdated — that cap was repealed.
Other clinicians in South Dakota: see the state overview.