PMHNP Practice Authority in Georgia: Independence, Physician Agreements and Schedule II
Georgia licenses psychiatric nurse practitioners as advanced practice registered nurses through the Georgia Board of Nursing, and every bit of prescriptive authority arrives by physician delegation through a nurse protocol agreement filed with the Georgia Composite Medical Board.
AANP classes Georgia as restricted, and delegation is career-long.
The limit that matters most: rule 360-32-.02 bars Schedule I and II drug orders, and the 2024 carve-out covers only emergency hydrocodone and oxycodone, so an outpatient Georgia PMHNP cannot prescribe Schedule II ADHD stimulants.
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At a glance
Advanced practice registered nurse (APRN).
The Georgia Board of Nursing licenses the APRN; nurse protocol agreements are filed with and reviewed by the Georgia Composite Medical Board.
Restricted, per AANP's State Practice Environment map (updated 05/2026).
AANP's label, not a legal category.
None: physician delegation is lifelong.
The sources read set no hours or years route out of the nurse protocol agreement.
A nurse protocol agreement signed by the APRN and a delegating physician, filed with the GCMB within 30 days of execution; under the 2024 changes the GCMB summary describes, a physician may supervise the combined equivalent of eight APRN protocol agreements and PA job descriptions at any one time.
Effectively no. Rule 360-32-.02(5)(c) bars Schedule I and II drug orders; the only exception is HB 557's emergency hydrocodone/oxycodone authority, under conditions including one year of post-licensure clinical experience, specific inclusion in the protocol, an initial supply of no more than five days and patients 18 or older.
Schedule II ADHD stimulants remain outside APRN authority.
Prescribable within the protocol's drug list; refills may not run more than 12 months from the original order (24 months for oral contraceptives, hormone replacement therapy or prenatal vitamins).
No day-supply cap is stated in the sources read.
Not enacted in Georgia.
The compact is not in effect anywhere: it needs seven states and five had enacted it as of September 2026.
The Georgia credential ladder
- Advanced practice registered nurse (APRN)(APRN)Other
The licence the Georgia Board of Nursing issues a PMHNP.
It carries no prescriptive authority by itself: prescribing must be delegated by a physician under a nurse protocol agreement (O.C.G.A. § 43-34-25 per the GCMB 2024 summary).
- APRN practising under a nurse protocol agreementOther
The PMHNP's prescribing status for the whole career: a written protocol mutually agreed and signed by the APRN and a delegating physician, filed with the Georgia Composite Medical Board within 30 days of execution, inside which the Schedule I/II bar of rule 360-32-.02 applies.
Restricted: prescriptive authority exists only by physician delegation
AANP's May 2026 map puts Georgia in its restricted tier.
The label is AANP's advocacy classification; the legal fact behind it is that an APRN's prescriptive authority is delegated by a physician under a nurse protocol agreement under O.C.G.A. § 43-34-25.
The Georgia Board of Nursing licenses the APRN, but the protocol that carries the prescribing belongs to the Georgia Composite Medical Board's system: it is submitted to the GCMB for review within 30 days of execution, and each agreement runs between one APRN and one delegating physician in a comparable specialty or field.
For what AANP’s full, reduced and restricted tiers mean, see can a PMHNP practice independently?
“Permits delegation of prescriptive authority as defined in the statute.”
No transition-to-practice route: delegation is career-long
Georgia sets no hours or years threshold after which a PMHNP stops needing the delegating physician.
A new graduate and a PMHNP with twenty years in practice stand under the same structure: a signed nurse protocol agreement, filed with the GCMB and reviewed annually.
No certificate, registration or attestation ends the delegation.
The only experience figure in the sources sits inside the HB 557 carve-out — at least one-year post-licensure clinical experience before an APRN may issue the emergency hydrocodone/oxycodone order — and it gates that exception, it is not a route to independence.
If you are weighing Georgia against an offer elsewhere, count the protocol agreement and the physician relationship behind it as a permanent cost of practice.
“None. Physician delegation is lifelong.”
The nurse protocol agreement: signatures, chart review and the eight-protocol cap
The protocol is written and signed by both, filed with the GCMB within 30 days of execution and reviewed annually; it must provide for immediate consultation with the delegating or a designated physician of the same scope.
Chart review is graded: 100% of controlled-substance patients' records signed at least quarterly; 100% of adverse-outcome records within 30 days of discovery; and 10% of all other records at least annually.
Under the 2024 changes described in the GCMB summary, a delegating physician may supervise the combined equivalent of eight APRN protocol agreements and PA job descriptions, previously four APRNs and four PAs.
At locations with evidence-based clinical practice guidelines and Board-approved accreditation, rule 360-32-.02(7)(b) lets a physician enter agreements with not more than eight APRNs and supervise not more than four, requiring 10% record review, quarterly collaboration meetings and 24-hour visit notice to the patient's consented primary care provider.
The delegating physician must hold an active Georgia licence, practise medicine in Georgia, and have a principal place of practice in Georgia or within 50 miles of where the protocol is used.
For who signs these agreements and what they cost, see PMHNP collaborative practice agreements.
“A delegating physician will be limited to entering and supervising 'the combined equivalent of eight' APRN protocol agreements and PA job descriptions at any one time. Previously, a delegating physician was limited to four APRNs and four PAs at any one time.”
Schedule II is effectively no: the only carve-out is emergency hydrocodone or oxycodone
The rule that decides psychiatric prescribing: nothing in rule 360-32-.02 authorizes an APRN to issue a prescription drug order for a Schedule I or II controlled substance, so Schedule II ADHD stimulants are outside an outpatient Georgia PMHNP's authority.
HB 557 (2024) added one narrow exception, per the GCMB: prescription drug orders for hydrocodone, oxycodone or compounds thereof in emergency situations, with conditions including at least one-year post-licensure clinical experience, good standing with the Board of Nursing, specific inclusion in the protocol agreement, a direct evaluation of the patient, an initial prescription not to exceed a five-day supply, a patient 18 years of age or older, and one hour of continuing education biennially.
That carve-out is opioids; it does not reopen stimulants.
Any patient who receives a controlled-substance prescription under the protocol must also be evaluated or examined by the delegating or a designated physician at least quarterly.
Refills may not run more than 12 months from the original order — 24 months for oral contraceptives, hormone replacement therapy or prenatal vitamins.
A state CS registration was not located.
For the federal DEA rules on prescribing controlled substances by telehealth, see prescribing controlled substances by telehealth.
“Nothing in this Rule shall be construed to authorize an advanced practice registered nurse to issue a prescription drug order for a Schedule I or II controlled substance or authorize refills of any drug for more than 12 months from the date of the original order except in the case of oral contraceptives, hormone replacement therapy, or prenatal vitamins which may be refilled for a period of 24 months as provided in O.C.G.A. 43-34-25.”
The DEA registration does not widen Georgia's limits — including by telehealth
A PMHNP registers with the DEA as a mid-level practitioner, and that registration covers only what Georgia allows.
The GCMB notes an APRN's DEA registration currently only permits the prescribing of Schedule III–V controlled substances, and that using the HB 557 carve-out requires a change to it.
Telehealth does not loosen the structure: the delegating physician's requirements — an active Georgia licence, practising medicine in Georgia, and a principal place of practice located within Georgia or outside Georgia but within 50 miles of where the protocol is utilized, which is the patient's physical location at the time services are rendered — apply unchanged when the APRN provides telehealth services.
The DEA and HHS telemedicine flexibilities, extended through December 31, 2026, remove the federal in-person-evaluation requirement for registered practitioners; they lift no Georgia limit.
For how an FNP moves into psychiatric practice, see FNP to PMHNP.
“If the APRN is providing telehealth services, the delegating physician must still meet all the above requirements.”
APRN Compact: not in Georgia, and not in effect anywhere
Georgia has not enacted the APRN Compact.
The compact comes into effect only once seven states enact it, and five had as of September 2026 — Delaware, North Dakota, South Dakota, Utah and Wyoming — so no APRN holds a multistate APRN licence today.
The Nurse Licensure Compact is an RN compact and confers no nurse practitioner authority in another state.
To practise as a PMHNP in Georgia you need a Georgia APRN licence and a Georgia nurse protocol agreement with a delegating physician.
2024 changes: the HB 557 carve-out, HB 1046 death certificates and the eight-protocol cap
The GCMB's June 24, 2024 summary describes the 2024 changes.
HB 557 created the § 43-34-25(d.1) emergency hydrocodone/oxycodone authority; HB 1046 lets physicians delegate death-certificate signing to the APRN, if specifically stated in the protocol, with biennial continuing education on recognizing and documenting causes of death.
The summary's limits section, citing § 43-34-25(g), (g.1) and (g.2), describes the cap at the combined equivalent of eight APRN protocol agreements and PA job descriptions, previously four APRNs and four PAs, and names no bill for it.
No effective dates are stated for any of these.
Rule 360-32-.02, which carries the Schedule I/II bar, has been in force since September 14, 2021 and, in the LII copy read, predates all of these changes — the GCMB notes existing protocols prohibit all Schedule II controlled substances in their current language and using the carve-out takes an addendum.
“This will require an addendum to any currently approved or submitted protocol, as all Schedule II controlled substances are prohibited in the current language.”
Filing mechanics: RN Practice Act practice continues during GCMB review
The GCMB reviews each protocol agreement for compliance after it is filed, and an APRN may be gainfully employed and working while that review is pending — still able, per the GCMB, to practise as permitted by the Registered Professional Nurse Practice Act (O.C.G.A.
Title 43, Chapter 26, Article 1).
Two operational traps sit in the same summary.
An incomplete protocol that stays on file more than three months — the clock starts when the GCMB sends its deficiency notification — is deemed invalid, and a new submission and fee are then required.
And some deficiencies cannot be cured at all, including the APRN and delegating physician not being in comparable specialties or fields, or the physician's principal place of practice falling outside the location radius.
The submission packet goes to the Board by email; the review fee is mailed separately and must carry the physician's and APRN's names.
“There is no provision under the Medical Practice Act that would prohibit an APRN from being gainfully employed and working while the review process is occurring.”
What This Page Does — and Doesn’t — Cover
This page summarizes the Georgia statute, rules, board pages and other documents cited above, as read for this state-by-state PMHNP practice authority series, current as of September 2026.
It does not list application forms, fees beyond those cited above, or processing times, and it is not a substitute for the instructions the Georgia Board of Nursing (APRN licence); nurse protocol agreements are filed with the Georgia Composite Medical Board publishes.
Hour totals, exams and supervision rules change by statute and by board rule; for how the PMHNP and psychiatrist roles compare, see PMHNP vs psychiatrist.
Confirm every requirement with the Georgia Board of Nursing (APRN licence); nurse protocol agreements are filed with the Georgia Composite Medical Board before you count hours, register for an exam or apply — and before you take one of the psychiatric nurse practitioner jobs in Georgia that asks for it.
Frequently Asked Questions
Can a PMHNP practice independently in Georgia?
No. Prescriptive authority exists only as delegated by a physician through a nurse protocol agreement, and the sources read set no hours or years route out of it — delegation is career-long.
AANP classes Georgia as restricted.
The protocol is signed by both parties, filed with the Georgia Composite Medical Board within 30 days of execution, and reviewed annually.
Confirm current requirements with the Georgia Board of Nursing and the GCMB.
Can a Georgia PMHNP prescribe ADHD stimulants?
No. Rule 360-32-.02(5)(c) says nothing in the rule authorizes an APRN to issue a prescription drug order for a Schedule I or II controlled substance, and amphetamine and methylphenidate products are Schedule II.
The HB 557 carve-out covers only hydrocodone, oxycodone or compounds thereof in emergency situations — opioid analgesics, not stimulants — under conditions including a five-day initial supply and patients 18 or older.
A DEA registration does not widen the Georgia limit.
How many nurse practitioners can one Georgia physician delegate to?
Under the 2024 limits in the GCMB's 2024 summary, one physician may enter and supervise the combined equivalent of eight APRN protocol agreements and PA job descriptions at any one time — previously four APRNs and four PAs — with the statute's enumerated exceptions.
At locations with evidence-based clinical practice guidelines and Board-approved accreditation, rule 360-32-.02(7)(b), from rule text effective September 14, 2021, allows agreements with not more than eight APRNs while supervising not more than four, with 10% record review, quarterly collaboration meetings and 24-hour notice of visits to the patient's consented primary care provider.
What does the delegating physician have to review?
Under rule 360-32-.02(7)(a), stated as the board's minimum accepted standards: 100% of patient records for patients receiving controlled-substance prescriptions, reviewed and signed at least quarterly; 100% of records in which an adverse outcome has occurred, within 30 days of discovery; and 10% of all other patient records at least annually.
Patients on any controlled substance must also be evaluated or examined by the delegating or a designated physician at least quarterly.
Do the DEA telehealth rules let a Georgia PMHNP prescribe stimulants remotely?
No. The DEA and HHS telemedicine flexibilities, extended through December 31, 2026, remove the federal in-person evaluation requirement for registered practitioners, but they do not lift state limits.
Georgia's rule bars Schedule I and II drug orders by APRNs, and that limit binds telehealth prescriptions the same as in-person ones.
The delegating physician's requirements — an active Georgia licence, practising medicine in Georgia, and a principal place of practice in Georgia or within 50 miles of where the protocol is utilized — also apply unchanged to telehealth.
More Georgia & Psychiatric Nurse Practitioner Resources
Sources
- Georgia Composite Medical Board, Important Information Regarding APRN Protocol Agreements (June 24, 2024) (retrieved 2026-09-24)
- Ga. Comp. R. & Regs. r. 360-32-.02, Requirements for Nurse Protocol Agreements Pursuant to Code Section 43-34-25 (Cornell LII) (retrieved 2026-09-24)
- AANP, State Practice Environment (updated 05/2026) (retrieved 2026-09-24)
- DEA/HHS, Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities (90 FR 61301) (retrieved 2026-09-24)
Sourced from the statute, rules, board pages and other documents cited above.
Verified September 2026.
This is career information, not legal or clinical advice — confirm current rules with the Georgia Board of Nursing (APRN licence); nurse protocol agreements are filed with the Georgia Composite Medical Board.