Alabama Requirements at a Glance
Practice Authority
Alabama is a Reduced Practice state (per AANP classification). Alabama NPs (CRNPs) must practice under a collaborative agreement with a physician, jointly approved by the Board of Nursing and the Board of Medical Examiners.
Path to Independence
No. The collaborative practice agreement is required for the duration of NP practice in Alabama.
Hours Required for Independence
N/A. Alabama does not offer a pathway to independent practice. However, the physician’s on-site presence requirement eases once the NP has two years (4,000 hours) of collaborative practice experience (see Meeting Requirements).
Physician-to-APC Provider Ratio Cap
Alabama limits physicians to collaborating with or supervising a combined total of 360 hours per week (equivalent to nine full-time providers). This limit applies nationwide across the physician’s agreements, not just within Alabama. Each NP or PA is counted only once. Employees of the Alabama Department of Public Health and county health departments are exempt.
Chart Review Requirements
Quarterly quality assurance review of each NP’s practice, including a meaningful sample of medical records plus all adverse outcomes. A physician collaborating with more than four full-time equivalents must conduct documented QA monthly for the first six months with each new NP. Documentation must be retained for the duration of the collaboration and three years after it ends.
Meeting Requirements
The collaborating physician must be present for at least 10% of the NP’s scheduled hours while the NP has less than two years (4,000 hours) of collaborative practice experience, either since initial certification or in the physician’s specialty. After that, the physician must meet with the NP at least quarterly. Remote practice sites must be visited at least twice a year. Certain practice settings are exempt from the presence minimum.
Geographic Requirements
The collaborating physician must be readily available for direct communication (in person, by radio, telephone, or telecommunications) and for consultation and referrals. A covering physician pre-approved by the Medical Board must be available when the collaborating physician is not. Services are deemed to occur where the patient is located, so Alabama rules apply to all care provided to Alabama patients.
Prescriptive/Delegation Authority Agreement
A Collaborative Agreement (jointly reviewed by the Alabama Board of Medical Examiners and the Board of Nursing) that specifies duties, work hours, and a quality-assurance plan. A separate Standard Protocol governs delegated clinical tasks. Both are submitted to the Alabama Board of Nursing.
Schedule II Prescribing
Alabama has strict Schedule II prescribing requirements, including additional permits, an approved formulary, and periodic in-person physician evaluations. Because these requirements involve direct patient care and our collaborating physicians do not provide that care, CollabDocs does not support Schedule II prescribing in Alabama. Please verify eligibility and requirements with the Alabama Board of Medical Examiners.
Physician Collaboration Eligibility Requirements
A collaborating physician in Alabama must:
- Hold a current, unrestricted Alabama medical license
- Have at least three years of practice since completing residency (or at least one year if certified by an ABMS or AOA specialty board, or one year if the practice site is limited to a general acute care, critical access, or specialized hospital licensed by the Alabama Department of Public Health)
- Complete Medical Board-prescribed CME on Alabama’s collaborative practice rules within 48 months before or 12 months after the collaboration begins, and every 48 months thereafter
- Keep total weekly collaboration hours within the 360-hour cap
- Pay the $200 commencement fee
- If the NP will prescribe controlled substances, hold a current, unrestricted Alabama Controlled Substances Certificate
DEA Requirements / Application Process
To prescribe Schedule III–V controlled substances, the NP must obtain a Qualified Alabama Controlled Substances Certificate (QACSC) from the Medical Board. Eligibility requires at least 12 months of active clinical practice in Alabama under an approved collaborative practice agreement (temporary or provisional approval time does not count), 12 hours of Board-approved controlled-substance CME, and a collaborating physician with a current, unrestricted Alabama Controlled Substances Certificate. A separate QACSC is required for each collaborative practice agreement and is renewed annually.
Schedule II prescribing also requires an LPSP. The NP must also hold an individual DEA registration. Quantity limits apply, and the collaborating physician must evaluate any patient on
Disclaimer: This page for general informational purposes only and is not legal or medical advice. Alabama requirements are set by state law and board rule and may change; consult your own counsel before relying on this information. CollabDocs facilitates physician-APC introductions and does not practice medicine or guarantee outcomes except as stated in a signed services agreement.
Reviewed by the CollabDocs Compliance Team | Last reviewed October 19, 2026
Alabama Requirements at a Glance
Practice Authority
Alabama is a Reduced Practice state (per AANP classification). Alabama NPs (CRNPs) must practice under a collaborative agreement with a physician, jointly approved by the Board of Nursing and the Board of Medical Examiners.
Path to Independence
No. The collaborative practice agreement is required for the duration of NP practice in Alabama.
Hours Required for Independence
N/A. Alabama does not offer a pathway to independent practice. However, the physician’s on-site presence requirement eases once the NP has two years (4,000 hours) of collaborative practice experience (see Meeting Requirements).
Physician-to-APC Provider Ratio Cap
Alabama limits physicians to collaborating with or supervising a combined total of 360 hours per week (equivalent to nine full-time providers). This limit applies nationwide across the physician’s agreements, not just within Alabama. Each NP or PA is counted only once. Employees of the Alabama Department of Public Health and county health departments are exempt.
Chart Review Requirements
Quarterly quality assurance review of each NP’s practice, including a meaningful sample of medical records plus all adverse outcomes. A physician collaborating with more than four full-time equivalents must conduct documented QA monthly for the first six months with each new NP. Documentation must be retained for the duration of the collaboration and three years after it ends.
Meeting Requirements
The collaborating physician must be present for at least 10% of the NP’s scheduled hours while the NP has less than two years (4,000 hours) of collaborative practice experience, either since initial certification or in the physician’s specialty. After that, the physician must meet with the NP at least quarterly. Remote practice sites must be visited at least twice a year. Certain practice settings are exempt from the presence minimum.
Geographic Requirements
The collaborating physician must be readily available for direct communication (in person, by radio, telephone, or telecommunications) and for consultation and referrals. A covering physician pre-approved by the Medical Board must be available when the collaborating physician is not. Services are deemed to occur where the patient is located, so Alabama rules apply to all care provided to Alabama patients.
Prescriptive/Delegation Authority Agreement
A Collaborative Agreement (jointly reviewed by the Alabama Board of Medical Examiners and the Board of Nursing) that specifies duties, work hours, and a quality-assurance plan. A separate Standard Protocol governs delegated clinical tasks. Both are submitted to the Alabama Board of Nursing.
Schedule II Prescribing
Alabama has strict Schedule II prescribing requirements, including additional permits, an approved formulary, and periodic in-person physician evaluations. Because these requirements involve direct patient care and our collaborating physicians do not provide that care, CollabDocs does not support Schedule II prescribing in Alabama. Please verify eligibility and requirements with the Alabama Board of Medical Examiners.
Physician Collaboration Eligibility Requirements
A collaborating physician in Alabama must:
- Hold a current, unrestricted Alabama medical license
- Have at least three years of practice since completing residency (or at least one year if certified by an ABMS or AOA specialty board, or one year if the practice site is limited to a general acute care, critical access, or specialized hospital licensed by the Alabama Department of Public Health)
- Complete Medical Board-prescribed CME on Alabama’s collaborative practice rules within 48 months before or 12 months after the collaboration begins, and every 48 months thereafter
- Keep total weekly collaboration hours within the 360-hour cap
- Pay the $200 commencement fee
- If the NP will prescribe controlled substances, hold a current, unrestricted Alabama Controlled Substances Certificate
DEA Requirements / Application Process
To prescribe Schedule III–V controlled substances, the NP must obtain a Qualified Alabama Controlled Substances Certificate (QACSC) from the Medical Board. Eligibility requires at least 12 months of active clinical practice in Alabama under an approved collaborative practice agreement (temporary or provisional approval time does not count), 12 hours of Board-approved controlled-substance CME, and a collaborating physician with a current, unrestricted Alabama Controlled Substances Certificate. A separate QACSC is required for each collaborative practice agreement and is renewed annually.
Schedule II prescribing also requires an LPSP. The NP must also hold an individual DEA registration. Quantity limits apply, and the collaborating physician must evaluate any patient on ongoing controlled-substance treatment in person at least once every 12 months.
Disclaimer: This page for general informational purposes only and is not legal or medical advice. Alabama requirements are set by state law and board rule and may change; consult your own counsel before relying on this information. CollabDocs facilitates physician-APC introductions and does not practice medicine or guarantee outcomes except as stated in a signed services agreement.
Reviewed by the CollabDocs Compliance Team | Last reviewed October 19, 2026
