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

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

The label is AANP's advocacy classification; the legal fact behind it is Section 73-15-20(3): an APRN performs authorized functions within a collaborative/consultative relationship with a dentist or physician holding an unrestricted Mississippi license, within an established protocol or practice guidelines filed with the board upon license application, license renewal, a new relationship, or a change to the protocol or practice site — and the board reviews and approves the protocol.

That subsection speaks generally of a physician or dentist, but subsection (7)(b) and Rule 1.4.C name a licensed physician whose practice is compatible with the nurse practitioner's, and give dentist collaboration expressly to CRNAs.

Mississippi has no hours or years threshold that ends the collaboration; what the rules have instead is a monitored-practice-hours entry gate.

Rule 1.3: the APRN may not practice at a site without a qualifying provider physically on the premises until the requirement is satisfied.

An APRN with less than one year (2,000 hours) of RN experience before completing an accredited APRN program owes 2,000 monitored practice hours; with one year (2,000 hours) or more, 1,000.

A qualifying provider is a licensed physician, a licensed dentist, or an APRN with a minimum of three years of active practice experience and similar educational preparation, of compatible practice.

Clinical hours earned during the APRN program count if national certification in the specialty arrives within two years of program completion, and APRNs with at least three years of active practice in another jurisdiction may be deemed to have satisfied the rule.

Finishing the hours releases the on-site condition — not the collaboration.

The agreement has two parts the board sees: the collaborative/consultative relationship and the protocol or practice guidelines, filed upon license application, license renewal, a new relationship, or a change, and the board reviews and approves the protocol.

Timing matters for starting a job: an APRN can hold State Certification without a formal collaborative agreement, but the agreement must be submitted to the board before practice begins, and a new or changed practice site needs board approval before the APRN practices there.

Every relationship must include and implement a formal QA/QI program maintained on site and available for board inspection.

If the collaborating physician cannot continue, Rule 1.2 says the APRN may be allowed a 90-day grace period, the Mississippi State Board of Medical Licensure or its designee serving as collaborative physician with the Board of Nursing's agreement; a further 90 days may be granted if both boards' executive committees agree.

Chart-review percentages and mileage requirements were not located in the nursing statute and rules read; they likely sit in Board of Medical Licensure rules, which were not read.

An outpatient Mississippi PMHNP can prescribe Schedule II ADHD stimulants: certified nurse practitioners who complete a board-approved program and receive board-granted prescriptive authority may prescribe Schedules II-V.

The only Schedule II stimulant rules located concern weight loss: no Schedule II drug for the exclusive treatment of obesity, weight control or weight loss, and weight-loss stimulants capped at a 30-day supply.

No general Schedule II stimulant/ADHD limit was located; the Part 2840 text read is the board's 2019 PDF, current version unconfirmed.

Schedule II opioids carry their own caps: acute-pain opioids stop at a 10-day supply plus 10 more if clinically necessary, and point-of-service drug testing precedes each Schedule II opioid prescription for chronic non-cancerous or non-terminal pain (except inpatient and hospice).

Methadone may not be prescribed for chronic pain, or for acute non-cancerous or non-terminal pain.

Benzodiazepines: a one-month supply with at most two refills, or a 90-day supply with none, plus drug testing before the initial prescription for a chronic medical or psychiatric condition and at least every 90 days after.

MPMP enrollment and use are required.

Two federal layers sit on top, and neither widens the state rules.

A PMHNP registers with the DEA as a mid-level practitioner, and that registration covers only what Mississippi allows; the board's rules require evidence of DEA registration filed with the board, with prescribing to stop if it lapses.

Under a facility DEA registration instead of an individual one, a certified nurse practitioner may determine the need for, order and administer controlled substances within a licensed health care facility — a licensed-facility carve-out, not an outpatient prescribing route.

The DEA and HHS telemedicine flexibilities, extended through December 31, 2026, remove the federal in-person-evaluation requirement but lift none of Mississippi's rules: the benzodiazepine limits, the opioid day caps and the MPMP checks apply to a telehealth prescription the same as an in-person one.

Mississippi 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 license today.

The Nurse Licensure Compact is an RN compact (Mississippi's APRN rule builds on it for RN licensure) and confers no nurse practitioner authority in another state.

To practice as a PMHNP in Mississippi you need Mississippi APRN certification, a collaborative/consultative relationship with an approved protocol and, for controlled substances, board-granted prescriptive authority.

The 2025 Regular Session produced two attempts to build a route out of the collaboration, and neither became law.

House Bill 98 would have exempted APRNs from entering and maintaining the collaborative/consultative relationship after completing 3,600 practice hours; it died in House committee on February 4, 2025.

House Bill 849 would have created the same exemption after 8,000 practice hours; it passed the House as amended on February 12 and died in Senate committee on March 4.

So the collaboration requirement stands as described on this page.

The 2026 session was not checked, and the Part 2840 rules cited here come from the board's 2019 PDF — confirm the current version with the board before relying on a number.