How to start an NP practice
in Georgia.

Georgia sits in an interesting spot: booming metro demand around Atlanta (the metro added 61,953 residents from 2024 to 2025, the 3rd-largest gain in the U.S.; U.S. Census Bureau), deep rural shortages everywhere else, and practice rules on the stricter end of the spectrum. About 2.7 million Georgians live in a primary care shortage area and 5.1 million live in a mental health shortage area (HRSA, as of December 31, 2025), so the need for better access to care is substantial. And, NPs absolutely open and own practices in Georgia. However, Georgia is notable because setting up a practice is easy but the collaborating physician arrangement and insurance contracting processes are harder than other states.

What are the key Georgia NP practice rules?

Georgia NPs practice under a nurse protocol agreement with a delegating physician, and current law has no path to independent practice.

Can a nurse practitioner own a practice in Georgia?

Yes. A Georgia NP can own their practice, and it can be set up as a standard LLC or a professional corporation (Georgia has no separate PLLC) (O.C.G.A. § 14-11-1107(f); § 14-7-2(2)). Georgia's restrictions live on the clinical side, not the ownership side.

What is a nurse protocol agreement and do I need one?

Yes, you need one before you treat patients. Georgia NPs practice under a nurse protocol agreement with a delegating physician (O.C.G.A. § 43-34-25(b)). It's a written agreement that spells out what you're authorized to do, including prescribing, and it comes with ongoing obligations for the physician around availability and periodic chart review (O.C.G.A. § 43-34-25(c)(2), (c)(5); Ga. Comp. R. & Regs. 360-32-.02). Georgia also caps how many NPs a physician can delegate to at once (the combined equivalent of eight APRNs or physician assistants; O.C.G.A. § 43-34-25(g)), so a physician with a full roster may not be able to take you on, which makes it harder to match. Your delegating physician also has to practice in Georgia, or within 50 miles of where your protocol is used if they practice out of state (O.C.G.A. § 43-34-25(a)(12)).

Georgia is also known for being particular about what the protocol covers, including limits around certain prescriptions (NPs can’t prescribe Schedule I or II controlled substances except emergency hydrocodone or oxycodone, and a patient on any controlled substance must be seen by a physician at least quarterly; O.C.G.A. § 43-34-25(k), (d.1), (c)(9)).

While requirements are more burdensome than other states, it’s still doable. Prax can recommend vetted partners to support a great physician match, if needed.

What happened with Georgia’s rules on paying a collaborating physician in 2026?

The Board’s position has softened, but the underlying statute hasn’t changed yet.

Georgia law makes it unlawful for a supervising physician to be an NP’s employee (O.C.G.A. § 43-34-25(n)). On May 7, 2026, the Georgia Composite Medical Board issued a position statement reading that rule to include “compensation of any kind, monetary or non-monetary, from an APRN or an APRN-owned company,” including payments to third-party physician matching companies (GCMB position statement). In a June 4, 2026 follow-up, the Board said the statement was “not to create new law or policy” and that it “is not terminating any currently active protocols as a result of the position statement” (GCMB statement, June 4, 2026).

Following strong advocacy from Georgia NPs, the Georgia Chapter of GAPNA reported that the Board agreed to (1) pull the compensation question (question 12) from the nurse protocol agreement, (2) stop denying protocols over compensation issues, and (3) work with the Governor’s office to remove the employment provision from the statute. NPs whose agreements were denied because of question 12 need to resubmit (Georgia Chapter of GAPNA). As of October 2026, the Board hasn’t posted these changes on its website, and the May 7 position statement is still posted.

Until the statute changes, how you structure the physician relationship still matters. This area is still moving, so feel free to reach out to the Prax team and we can help you think it through.

What entity does a Georgia NP practice use?

Georgia NP practices can be set up as a standard LLC or a professional corporation (Georgia has no separate PLLC) (O.C.G.A. § 14-11-1107(f); § 14-7-2(2)). State filing is relatively inexpensive and fast.

In Georgia especially, the filing is the easy part. The collaborating physician arrangement and insurance contracting are where the real work is.

The Prax Practice Launch Kit covers a lot of the practice setup in Georgia (entity formation, governing documents, registered agent, virtual business address, the nurse protocol agreement framework with physician matching where needed, and the complete patient consent packet with telehealth consent). That said, most NPs will need to work with a group like Prax to set up payer contracts with most major payers in Georgia.

How much does it cost to start an NP practice in Georgia?

Georgia's setup fees are among the lowest of the big states, with state entity filing of just $100 (online LLC filing). But, the delegating physician relationship is the meaningful recurring cost - easily $500 to $1,500 per month depending on the arrangement. This is because in Georgia the supply of available physicians is tighter than other states due to the delegation caps.

How long does it take to launch in Georgia?

The entity side moves in days to a couple of weeks, and most Georgia NPs working with Prax are fully set up within 1-2 weeks. The pacing item is usually setting up your collaborating physician match and protocol. Insurance credentialing frequently adds 90 to 150 days per payer, and should be started as early as possible, and at latest when your entity is formed.

Can Georgia NPs get in-network with insurance companies?

Yes, but it’s harder than in many states. Insurance is notoriously difficult for nurse practitioners in Georgia, and several major payers will not directly contract with Georgia NPs. That leaves three main options: (1) continue working in a larger health system or employed setting, (2) practice but plan to not be in-network with a few major payers, or (3) work with a medical group like Prax, which has group contracts in place and can help get you in-network even when a payer won’t contract with you individually. Book a call with the Prax team to learn more.

Can I run a telehealth practice in Georgia?

Yes, and telehealth is especially valuable in Georgia where there are large primary care and mental health shortage areas, and virtual care is how NPs reach them. Your protocol agreement needs to reflect a telehealth model and your consent packet needs telehealth language. Georgia also holds telemedicine to "the same standard of care" as in-person care (Ga. Comp. R. & Regs. 360-3-.07).

Frequently asked questions

Does my delegating physician own part of my practice? No. Delegation is entirely clinical, and completely separate from practice ownership. The business is yours. Uniquely, Georgia law also makes it unlawful for a supervising physician to be your employee (O.C.G.A. § 43-34-25(n)).

Does the protocol requirement expire with experience? No. Georgia has no hours-based independence path under current law (O.C.G.A. § 43-34-25(b)).

Why is finding a delegating physician harder in Georgia? Delegation caps limit how many NPs each physician can work with (the combined equivalent of eight APRNs or physician assistants; O.C.G.A. § 43-34-25(g)), so supply is constrained. Start the search early or work with a third party group who can facilitate a great match. (If you’re not sure, please just let us know. We have vetted recommendations.)

Is Atlanta or rural Georgia better for a new practice? Both work for different models. Metro Atlanta suits in-person primary care practices. Rural Georgia rewards telehealth and primary care plays to increase access.

Can Georgia NPs prescribe Schedule II controlled substances? Only in narrow cases. Georgia law doesn’t authorize NPs to prescribe Schedule I or II drugs, except that an NP with at least one year of post-licensure clinical experience may be authorized to prescribe hydrocodone, oxycodone, or compounds thereof “in emergency situations,” limited to an initial prescription of no more than a five-day supply for adults (O.C.G.A. § 43-34-25(k), (d.1)).

What's the first step? Entity formation first, then set up your collaborating physician and insurance enrollment in parallel. A free call with the Prax team can help you get all tracks started.

This guide is for general information only and isn't legal, tax, or medical advice. Georgia requirements change. Talk with a qualified professional about your situation.

Last reviewed: October 5, 2026. Reviewed by: Prax Health Research Team.