Nurse Practitioner Scope of Practice: Massachusetts

By ThriveAP Team Member Leonel Cabrera

Home to the heralded Boston Celtics and Red Sox, Massachusetts is well known for its ample history and its reputation as a breeding ground for famous authors, actors and athletes.  Some notable figures include former president John F. Kennedy and inventor Ben Franklin.  Controversial novelists such as Edgar Allan Poe and women’s freedom advocate Susan B. Anthony started their legacies here.  But, do the laws regulating nurse practitioners in Massachusetts give them the potential for greatness as well?

Despite having the title “nurse practitioner” in common, each state has different rules and regulations governing NP’s scope of practice.  Let’s take a look at the laws overseeing nurse practitioners in Massachusetts.

Massachusetts Nurse Practitioner Supervision Laws

Nurse practitioners in Massachusetts are not required to have physician oversight in diagnosing and treating patients.  However, MD involvement is required to prescribe.  This means that to practice to their full potential, nurse practitioners in Massachusetts must have a collaborative practice agreement with a physician.  The physician does not need to be on-site but must be available for consultation with the NP in person or by phone.

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The physician collaborating with the nurse practitioner must have a similar area of expertise to the NP.  For example, a pediatric NP may have a pediatrician or family practice physician as a collaborator.  There is no restriction on the number of nurse practitioners a single MD is allowed to supervise at one time.  Massachusetts does recognize nurse practitioners as official primary care providers.

Massachusetts Nurse Practitioner Prescribing Laws

For an NP to have prescriptive authority in Massachusetts he/she must sign a collaborative agreement specifying the NP’s scope of practice.  The nurse practitioner’s charts must be reviewed at least once every three months in regards to prescribing but no specific quantity of chart reviews is required.  Prescribing authority ranges from Schedule II to Schedule IV drugs.  However if the NP prescribes Schedule II drugs, the chart must be reviewed within 96 hours. On all prescriptions, the physician’s name must be present.

Nurse practitioners in Massachusetts are prohibited from self-prescribing Schedule II, III, and IV drugs for personal use.  NP’s are also prohibited from prescribing Schedule II drugs to family members except in emergency situations.

Other Massachusetts Scope of Practice Laws

Nurse practitioners in Massachusetts can sign death certificates after a reasonable attempt to contact a medical examiner or supervising physician.  NP’s are also allowed to sign handicap parking permits.

Massachusetts is largely a “hit-or-miss” state when it comes to NP’s.  The scope of practice is not as extensive as in some states but it is less restrictive than others.

4 thoughts on “Nurse Practitioner Scope of Practice: Massachusetts”

  1. judy jorge-leonard

    I am a Psych NP and have been told I only need 1 Psych MD to supervise across more that 1 care setting. I work in a hospital based outpatient clinic as well as in a private practice. Should I have a supervising MD for the hospital based setting and a different one for private practice or ask the MD where I do more time at the hospital based practice to supervise me in private practice as well (both stings)?

  2. Catherine Garwood

    Date: 2/27/21: Governor Baker signed legislation 1/1/21 that nurse practitioners have an expanded role and “full authority” of practice.
    1. Does this now mean, that nurse practitioners in MA no longer need a supervising physician or collaborative agreement.?
    2. And can write schedule II class medication without MD co-signatures within 96 hours ?
    3. I am working in a MMTP (prescribing methadone), per SAMHSA a wavier in needed for an NP to prescribe methadone. As this is a federal regualtion, will this waiver still be needed for prescribing methadone?
    Thank you for your review. I look forward to your feedback,
    Catherine Garwood

  3. griselis mckiernan

    does an NP needs a co-signature on the psychiatric evaluations, master treatment plans, physician progress notes, and dc summary.,…………..from an MD?

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