Collaborating Physicians in Florida: What NPs and PAs Actually Need

Path One: Autonomous Practice

This is the first thing to check, because it can make everything else unnecessary.

Florida's autonomous practice registration exempts qualifying APRNs from the requirement to work under an established protocol. The Board of Nursing sets four eligibility criteria:

1. A clear, active Florida APRN license
2. At least 3,000 clinical hours supervised by an allopathic or osteopathic physician within the past five years
3. Three graduate-level semester hours in differential diagnosis and three in pharmacology, both completed within the last five years
4. No disciplinary action in the past five years

The clinical hours requirement is the one that most often disqualifies people — it's roughly a year and a half of full-time practice, and it must be supervised and recent.

One important limitation to check before you count on this. Florida's autonomous practice pathway is oriented toward primary care, and some sources indicate the qualifying hours must be in primary care as well. If you practice in a specialty — psychiatry, aesthetics, or anything outside family medicine, general pediatrics and general internal medicine — do not assume autonomous registration is open to you on hours alone. Confirm your specific eligibility with the Board of Nursing before building a plan around it.

If you qualify, register. It removes an ongoing cost and an ongoing dependency. Any service that tells you otherwise isn't being straight with you.

If you don't qualify — whether on hours or on specialty — a collaborating physician is what you need, and it isn't a temporary inconvenience you'll age out of.

Path Two: The Supervisory Protocol

If you're not autonomously registered, Florida requires a written protocol with a supervising physician. The process:

1. Draft the supervisory protocol. The Board of Nursing publishes an APRN Protocol format — use it as your template rather than starting from scratch.
2. Both parties sign it.
3. Keep a copy at every practice site. Not one copy in a central office — a copy maintained on site at each location where you practice.
4. The physician files notice with the Board of Medicine within 30 days of signing. This is the physician's obligation, not yours — which is exactly why it gets missed.
5. If the collaboration ends, the physician files a termination notice with the Board of Medicine within 30 days.

The office supervision limit

Florida caps how many offices a physician may supervise remotely: four for primary care, two for specialty practice. There's no cap on the number of NPs. So the question to ask a prospective supervising physician isn't how many providers they oversee — it's how many practice sites they're already remotely supervising, and whether those are primary care or specialty.

Prescribing in Florida: The Details That Matter

Schedule II is capped at a 7-day supply for APRNs — with one significant exception. That restriction does not apply to psychiatric medications prescribed by psychiatric nurses. For a PMHNP managing stimulants or other Schedule II psychiatric medications, this is the difference between a workable practice and a constant refill burden.

Psychiatric controlled substances for children under 18 may only be prescribed by APRNs who are also psychiatric nurses.

Florida requires state-level controlled substance registration in addition to your federal DEA. Budget the time for it; it's a separate step people discover late.

What a Collaborating Physician Costs in Florida

Florida runs higher than most states, and there's a structural reason worth understanding.

The office supervision cap limits each physician to remotely supervising four primary care sites or two specialty sites. That puts a hard ceiling on how much supervision capacity exists in the state — and constrained supply against steady demand pushes rates up. It isn't that Florida physicians charge more by temperament; there are simply fewer available supervision slots than the market wants. Specialty practices feel it most, since those physicians are capped at two sites rather than four.

Knowing that changes how you should approach it. An NP contacting physicians cold in Florida is negotiating from a weak position in a seller's market.

This is where a network genuinely helps. Because we bring physicians consistent, pre-vetted matches rather than one-off inquiries, we can negotiate rates down from what you'd typically be quoted approaching someone individually. That's not a marketing claim about being nice — it's the ordinary economics of being a repeat counterparty rather than a stranger.

And autonomous practice changes the calculation — if it's actually open to you. If you're eligible, the right answer may be to register rather than pay anyone. But because the pathway is oriented toward primary care, specialty NPs often can't take it regardless of how many hours they've accumulated. Check your eligibility before assuming a collaboration is temporary.

At MD-Match, pricing is tailored to your practice rather than flat-rated. If you tell us you're close to autonomous eligibility, we'll tell you — and price accordingly rather than pretending you need us indefinitely. The match fee is $50, one time, and rematching is free, always.

Mistakes I Actually See in Florida Arrangements

Paying for a collaboration you don't need.

The single most expensive Florida mistake. NPs who qualify for autonomous registration, or are close, paying monthly for a protocol they could have removed. Check your eligibility before you sign anything.

The notice that was never filed.

The physician has 30 days to file notice with the Board of Medicine. It's their obligation, so the NP assumes it's handled and the physician forgets. The protocol exists; the notice doesn't.

Protocols in one place instead of every place.

Florida requires a copy on site at each practice location. NPs working across multiple sites often keep one signed original at their main office and nothing at the others.

The physician at their office cap.

Four primary care sites, two specialty. A physician already at the limit can't legitimately add you, and headcount questions won't reveal it.

Missing the 7-day Schedule II reality.

Non-psychiatric APRNs discovering the cap after building a practice model that assumed monthly prescribing.

Termination notice not filed.

The collaboration ends, everyone moves on, and no one files the 30-day termination notice with the Board of Medicine.

Every physician in the MD-Match network is background-checked, license-verified for Florida, and checked against their remote office capacity before matching. We track the 30-day filing deadlines rather than trusting they'll be remembered.

How MD-Match Works in Florida

1. Complete the free intake form — credential, specialty, practice setting, timeline. First step takes about two minutes.
2. Get an honest assessment. I review every Florida submission myself. If you look eligible for autonomous practice, I'll say so — that's a better outcome for you than a collaboration.
3. Pay the one-time $50 match fee and get matched with a Florida-licensed, specialty-aligned physician who has genuine remote office capacity.
4. We handle the compliance rails — protocol drafting from the Board's format, the 30-day Board of Medicine notice, site copies, and termination filing if it ever ends. If a match stops working, rematching is free.