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

AANP's May 2026 map classes Louisiana as reduced.

The legal fact behind the label is the Board of Nursing's authorized-practice rule: an APRN who engages in medical diagnosis and management must hold a collaborative practice agreement covering physician availability for consultation or referral, clinical practice guidelines, and coverage of patients during any absence of the APRN, physician or both.

The rule does carry one carve-out — APRNs practising under R.S.

37:913(3)(a) need no agreement — but R.S.

37:913 was not among the sources read, so this page cannot say which APRNs that clause covers.

What the rule makes plain is that the agreement has no exit: nothing in it converts collaboration into independence after hours or years.

The 500 hours are the entry requirement for prescriptive and distributing authority, not a step toward it — collaboration continues after they are met.

The rule counts them as clinical practice as a licensed APRN or APRN applicant, within two years, in the role and population focus the applicant was educated for, immediately before the application, and expressly allows out-of-state APRN practice and graduate-program clinical hours to be accepted.

Alongside them sits a minimum of 45 contact hours of education (a 3 credit hour academic course) in advanced pharmacotherapeutics; the rule sets the same 45-hour requirement for advanced physiology/pathophysiology and advanced health assessment.

Keeping the authority takes six contact hours of pharmacotherapeutics continuing education each year, and any deviation from the hour or course clauses goes to the board for review and approval.

The agreement lives on a board form retained at the practice site, with no more than two collaborating physicians per site unless the board approves a deviation.

The collaborating physician must be available face-to-face, by telephone or direct telecommunications for consultation, medical emergencies or referral, and the clinical practice guidelines are reviewed and signed at least annually by the APRN and physician.

Changes to collaborating physicians or sites need a written request for board approval within 30 days; adding or replacing a collaborating physician needs that request beforehand, except during a declared emergency or disaster, when an APRN may practise at an unreported new site with a previously approved physician.

A sole collaborating physician ending the agreement for predictable, voluntary reasons must give no less than 30-days notice.

For an unpredictable or involuntary loss, the alternate-physician route applies only where the practice site has a single, sole collaborating physician, and the ACP must be identified with that physician in advance.

No chart-review percentage, mileage rule or APRN ratio is located in the sources read.

Said plainly: an outpatient Louisiana PMHNP can prescribe Schedule II ADHD stimulants.

Controlled-substance prescribing is its own board authorization: the APRN must first hold board approval to prescribe and distribute non-controlled substances, and the board may then authorize controlled substances on an individual practice basis.

Once authorized, Schedules II through V are limited to, consistent with, and exclusively within the parameters of the practice specialty of the collaborating physicians and the APRN's licensed role and population focus — and no day-supply limit on Schedule II is located in the sources read.

A psychiatric practice therefore needs collaborating physicians whose specialty covers psychiatric prescribing, an agreement showing the controlled substances were jointly agreed upon, and an application stating an identified need for controlled substances in the patient population served.

Initial approval requires three hours of board-approved CE covering drug diversion training, best practices and addiction treatment.

Prohibited: controlled substances for chronic or intractable pain, obesity, or oneself, a spouse, child or other family member.

Prescribing requires an active Louisiana controlled dangerous substance licence and DEA registration first.

A Louisiana PMHNP registers with the DEA as a mid-level practitioner, and that registration covers only what Louisiana allows.

The state layer sits underneath it: the rule requires obtaining and possessing an active Louisiana controlled dangerous substance licence and a DEA registration number before prescribing or distributing controlled substances.

The rule also reaches the remote visit itself: an APRN prescribing by an electronic means, over the Internet or over telephone lines must perform and appropriately document a history and physical examination and make a diagnosis, and no APRN shall prescribe a controlled substance without a good faith prior examination and medical indication.

The DEA and HHS telemedicine flexibilities, extended through December 31, 2026, let registered practitioners prescribe Schedules II through V remotely without the federal in-person-evaluation requirement, but they lift no state limit — the collaborative practice agreement, the specialty parameter, the examination documentation and the licence prerequisites all apply to a remote prescription just as they do in person.

Louisiana has not enacted the APRN Compact — it is not among the five enacting states found (Delaware, North Dakota, South Dakota, Utah and Wyoming).

The compact comes into effect only when seven states enact it, so no APRN holds a multistate APRN licence today.

The Nurse Licensure Compact is an RN compact and gives no nurse practitioner authority.

A PMHNP moving to Louisiana needs a Louisiana RN licence, a Louisiana APRN licence from the Board of Nursing, and — for medical diagnosis and management — a Louisiana collaborative practice agreement with a board-approved collaborating physician.

The amendment history carried on the rule text ends at LR 45:1202, effective September 1, 2019, and no 2023–2026 change to Louisiana's APRN collaboration or prescribing rules is located in the sources read; 2023–2026 bills were not checked.

One structural caveat for planners: the collaborative-practice provisions the rule implements sit in R.S.

37:913, the statute the rule cites — and R.S.

37:913 was not among the sources read, so a statutory amendment would not surface in the rule's own history.

Confirm current text with the Louisiana State Board of Nursing before relying on any time-sensitive detail.