A Missouri collaborative practice arrangement has to set out how the advanced practice nurse and the collaborating physician will maintain geographic proximity. No distance is attached to that phrase anywhere in the statute. All the numbers live in the exceptions.

Median Healthcare Salaryin Missouri

10%$16.00/hr

median$25.00/hr

90%$105.00/hr

Top Median Salary by Rolein Missouri

Physician$105.00/hr
Nurse Practitioner$61.48/hr
Pharmacist$60.00/hr
Pharmacy Intern$23.75/hr
Medical Scribe$22.73/hr

Top Open Rolesin Missouri

The four ways around a requirement with no number

Correctional centers held the only proximity distance the statute ever named, 200 miles by road, and that allowance ran until August 28, 2025. Rural health clinics can have proximity waived for up to 28 days a calendar year, though the branch reaches only independent clinics, provider-based clinics whose provider is a critical access hospital, and provider-based clinics more than 50 miles from their hospital sponsor's main location. An arrangement that lays out the use of telehealth can have it waived as well. The fourth route is an application to both boards, open where a physician is collaborating in excess of a proximity limit, and the boards approve it if they determine that adequate supervision exists. They get 45 calendar days, and if no action is taken in that time the application is deemed approved. A fifth branch is no way out at all, since it simply makes the physician keep the documentation and show it to the healing arts board on request.

Healthcare jobs in Missouri by role

Your questions about healthcare jobs in Missouri, answered

How many advanced practice nurses can one Missouri physician collaborate with?: Six is the cap, and the count is shared. Advanced practice registered nurses, licensed physician assistants and assistant physicians all draw on the same 6 full-time equivalents in any combination, so a practice's existing physician assistants shrink the room for a Missouri nurse practitioner. Three arrangements sit outside the cap: hospital employees providing inpatient care service in hospitals as chapter 197 defines them, population-based public health services as the rules defined them on April 30, 2008, and a certified registered nurse anesthetist giving anesthesia under an anesthesiologist or other physician, dentist or podiatrist who is immediately available if needed.
Does a new Missouri advanced practice nurse start out alone?: No. The collaborating physician has to determine and document the completion of at least a one-month period during which the nurse practices with that physician continuously present, before the nurse works anywhere the physician isn't. Two arrangements are carved out of it, providers of population-based public health services and a pairing inside one specialty, a primary care physician with a primary care nurse or a behavioral health physician with a behavioral health nurse, where the physician is the one new to a patient population the nurse already knows. The documenting duty sits with the physician, so a nurse changing jobs depends on somebody else's records.
How long can a Missouri controlled substance prescription run?: A Schedule III narcotic or Schedule II hydrocodone prescription is held to a 120-hour supply with no refill. Buprenorphine for medication-assisted treatment runs to 30 days without refill, under the collaborating physician's direction. What can be delegated at all is set by the arrangement, and the one thing it may never delegate is authority to administer those same controlled substances to induce sedation or general anesthesia for a therapeutic, diagnostic or surgical procedure. Full Schedule II opens in one situation only, for hospice patients, where the nurse works for a certified hospice that the arrangement names as a place of practice.