PMHNP Practice Authority in Indiana: Independence, Physician Agreements and Schedule II

AANP's May 2026 map puts Indiana in its reduced tier.

The label is AANP's advocacy classification; the legal fact behind it is IC 25-23-1-19.4(c): an advanced practice registered nurse shall operate in collaboration with a licensed practitioner as evidenced by a practice agreement, or through privileges granted by a hospital's governing board that set out how the APRN and the licensed practitioner will cooperate, coordinate and consult.

The collaboration is career-long, with no exit in the statute or rule read.

For a job seeker the practical reading is that a private-practice or clinic PMHNP role means signing and maintaining a practice agreement, while a hospital-employed role may run on privileges instead.

Indiana sets no hours or years threshold after which an APRN stops needing the practice agreement, so a new graduate and a PMHNP with twenty years in practice work under the same structure.

The statute and rule read contain no exit route; collaboration, or hospital privileges in its place, is a permanent feature of Indiana practice.

If you are weighing an Indiana offer against one elsewhere, count the agreement as a career-long cost of practice, not a start-up phase — and note that the hospital-privileges route in IC 25-23-1-19.4(c) is an alternative structure, not an independence threshold.

The board's rule says the written agreement shall contain at least the following information: the parties' complete names and addresses, all other offices or locations where the practitioner authorized prescribing, both parties' specialty or board certifications, the specific manner of collaboration — working together, sharing practice trends and responsibilities, maintaining geographic proximity (no mileage is stated) and providing coverage during the licensed practitioner's absence, incapacity, infirmity or emergency — any limitation the licensed practitioner has placed on the APRN's prescriptive authority, a list of all other written practice agreements of both parties, and the agreement's duration.

Review is concrete: the APRN submits documentation of prescribing practices to the practitioner within seven (7) days, including at least a five percent (5%) random sampling of charts and medications.

An agreement is not valid until the board grants prescriptive authority, and the APRN must immediately notify the board in writing of changes in, or termination of, written practice agreements — including changes in the prescriptive authority of the collaborating licensed practitioner.

No cap on APRNs per practitioner was located.

Prescriptive authority runs through a board program under which qualifying APRNs are authorized to prescribe drugs, including controlled substances, in accordance with IC 25-1-9.3.

The statute and rule read contain no Schedule II-specific limit, so those sources do not bar an outpatient Indiana PMHNP from prescribing Schedule II ADHD stimulants.

Within those sources, the only limits are the ones the practitioner records in the practice agreement (848 IAC 5-1-1(a)(7)(E)); the grant also runs in accordance with IC 25-1-9.3, whose text was not read.

Eligibility includes a graduate pharmacology course of at least two (2) semester hours and national certification or a portfolio equivalence.

A course older than five (5) years triggers the rule's alternative under 848 IAC 5-1-1(a)(6): proof of both thirty (30) contact hours of continuing education in the prior two years, including at least eight (8) in pharmacology, and prescriptive experience in another jurisdiction within the prior five.

Prescribing any controlled substance takes an Indiana controlled substances registration plus a federal DEA registration.

A PMHNP registers with the DEA as a mid-level practitioner, and that registration covers only what Indiana allows — in Indiana's case the operative state limit is not a schedule list but the practice agreement's recorded limitations and the board-granted authority itself.

The DEA and HHS telemedicine flexibilities, extended through December 31, 2026, let registered practitioners prescribe controlled substances remotely without an in-person medical evaluation, but they lift no Indiana limit: the practice agreement and its recorded limitations still govern what the APRN may prescribe.

The flexibilities run to a fixed end date in the federal rule, so recheck before relying on them past 2026.

Indiana 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.

Indiana's own rule shows the difference: a prescriptive-authority applicant may rely on an active, unrestricted RN license from another compact state, filing a Multi-state Privilege Notification Form with the health professions bureau — but that covers the RN layer of the application only, and the APRN authority and prescriptive authority are Indiana grants.

To practise as a PMHNP in Indiana you need Indiana's prescriptive authority and a valid practice agreement.

The Board of Nursing's prescriptive-authority rule, 848 IAC 5-1-1, was readopted with a filing of July 31, 2024 (document 20240828-IR-848230831RFA) — a procedural act keeping the existing rule in force, not a change to its terms.

No 2023–2026 statutory change to IC 25-23-1-19.4 or 19.5 was located in the sources read.

Both documents carry their own clocks: the FindLaw statute text is current as of January 1, 2026, and the Indiana General Assembly's site renders by JavaScript, so check iga.in.gov and the board before assuming nothing has moved.

One Indiana quirk matters to PMHNPs specifically: for Medicaid, an APRN licensed under IC 25-23-1-19.5 who has been educated and trained to work with patients with addiction and mental health needs has all of the supervisory rights and responsibilities, including prior authorization, that are available to a licensed physician or HSPP operating in a community mental health center certified under IC 12-21-2-3(5)(C).

Subsection (d) states two conditions for the APRN: the IC 25-23-1-19.5 licence and that education and training.

It measures the APRN's rights against those of a physician or HSPP operating in a certified community mental health center, and it does not say how the rights apply outside that setting.

For a psychiatric NP weighing CMHC work, the practical reading is that Medicaid prior-authorization authority held by CMHC physicians and HSPPs can sit with a qualifying APRN.

Confirm with the board, Indiana Medicaid and a given center how it applies.