Nurse practitioner full practice authority by state in 2026:
required hours, and what FPA actually removes.

“Full practice authority” is the phrase every NP hears when they start thinking about their own practice, and it’s also the most misunderstood one. It doesn’t mean you can’t open one if your state lacks it, and it often comes with a transition period to full authority. Here is where every state stands as of fall 2026, what changed this year, and what FPA does and doesn’t get you.

How many states have full practice authority for nurse practitioners?

Twenty-seven states plus the District of Columbia, according to the American Association of Nurse Practitioners map as of its May 2026 update. Twelve states are “reduced practice,” and eleven are “restricted.”

Two states enacted paths to independent practice in 2026 that AANP has not reclassified. New Jersey signed a law in March letting experienced NPs practice without a joint protocol in primary care and behavioral health. Wisconsin’s APRN Modernization Act took effect September 1 with an independent practice route after a supervised period. Both have carve-outs, so whether AANP eventually moves them to the full column is an open question. No state was added to AANP’s full practice list in 2025 or 2026. The last additions were Utah in 2023 and Kansas and New York in 2022.

If you read a site claiming 29 or 30 full practice states, it’s counting territories or double-counting. The AANP number is 27 plus DC.

Does full practice authority mean I can practice independently on day one?

In about half of full practice states, yes. In the rest, no. Many full practice states require a transition period under a physician or an experienced NP before you can practice or prescribe without an agreement. The hours vary widely, from 750 in Colorado to 4,000 in Delaware, and they are a real planning constraint for a new graduate or an NP moving from another state.

The reverse is also true. Several reduced and restricted states have their own hours-based path out of the collaborative agreement. New York’s is 3,600 hours. Florida’s is 3,000 hours, but only for primary care. Illinois is 4,000 hours plus 250 hours of continuing education. Oklahoma’s new law is 6,240 hours. AANP doesn’t count these as full practice because the agreement is still the default, but for an NP with the hours, the practical result is close.

What does each state require in 2026?

The table below uses AANP’s category and the state’s own transition rule. “Nothing” in the last column means that once the transition is done, no ongoing agreement is required. Where a state guide exists, it’s linked.

What changed in 2025 and 2026?

More movement than in any recent year, though most of it stopped short of full practice authority.

New Jersey (March 30, 2026). Governor Sherrill signed S2996, which lets NPs with more than 5,000 hours of advanced practice work without a joint protocol when providing primary care or behavioral health care in one of five population foci: family, adult-gerontology, pediatrics, women’s health, and behavioral health. General obstetrics and elective aesthetic services are excluded. The law replaced a COVID-era waiver that was about to expire, and hours worked under that waiver count.

Wisconsin (September 1, 2026). The APRN Modernization Act created an APRN license and an independent practice path after 3,840 hours of advanced practice with a physician available for consultation, over at least two years. Independent APRNs have to carry malpractice coverage at the state fund’s levels and participate in the fund. Pain management practice outside a hospital still requires collaboration, and employers can still require it.

New York (May 2026). The NP Modernization Act was not made permanent, but its sunset was pushed from July 1, 2026 to July 1, 2030 in the state budget. The 3,600-hour threshold didn’t change.

Maine (February 17, 2026). The legislature unanimously repealed the 24-month supervised practice period for new NPs as emergency legislation. The Board of Nursing is replacing it with a mentorship requirement set by rule, proposed at one year, and the final rule hadn’t been adopted as of this writing. Maine stays a full practice state either way.

Oklahoma (November 1, 2025). After a veto override, NPs with 6,240 supervised hours can apply for independent prescriptive authority. Schedule II is still off the table.

North Carolina (September 2026). A family NP sued the state medical and nursing boards, arguing the collaborative practice agreement requirement violates the state constitution. She pays $16,500 a year for an agreement covering herself and four other NPs, and the physician isn’t required to see her patients or review her charts. No ruling yet, but it’s the first case of its kind and worth watching if you’re in a restricted state.

Stalled. Pennsylvania’s bills (SB 25 and HB 739) haven’t had a hearing and the session ends November 30. South Carolina’s bill sat in committee all session and advocates plan to refile in 2027. Michigan’s HB 4399 cleared a House committee in November 2025 with a 1,000-hour experience requirement added and has been sitting in Rules since. Ohio has three bills pending (HB 449, HB 508, and SB 258) with transition periods of 2,000 to 5,000 hours, all opposed by the state medical association and none voted on. Florida’s attempt to extend autonomous practice to psychiatric NPs and CRNAs passed the House and died in the Senate in March. Minnesota’s attempt to remove its 2,080-hour transition was withdrawn in May.

What does full practice authority actually remove?

Three things, all at the state licensing level.

First, the mandated agreement. In a full practice state, no collaborative, supervisory, or delegation agreement is a condition of your license or your prescribing once any transition period is done. Second, the obligations that only exist because of that agreement: chart review percentages, physician ratios, protocol filings, meeting schedules. Third, the fee. NPs in restricted states typically pay a collaborating physician $450 to $750 a month, and in some states more than $1,000. That goes away.

Full practice states also regulate NPs under the Board of Nursing alone, rather than jointly with the medical board.

What doesn’t full practice authority remove?

This is the list that surprises people.

Entity and ownership rules. FPA is a licensure rule, not an ownership rule. Corporate practice of medicine doctrine, professional entity requirements, and the question of who can co-own your practice are all unchanged. Our legal entity guide covers what each state requires.

Payer credentialing. Medicare, Medicaid, and every commercial plan still credential you the same way, on the same 90 to 150 day timeline. FPA doesn’t speed that up.

The Medicare 85 percent rule. Medicare pays NPs 85 percent of the physician fee schedule regardless of practice authority. Some commercial payers pay 100 percent. The state law doesn’t touch this.

DEA registration and state controlled substance licenses. You still need your own DEA registration ($888 for three years) in each state where you prescribe controlled substances, and 25 jurisdictions require a separate state controlled substance license first. Several full practice states also keep their own controlled substance limits. Nevada requires two years or a protocol for Schedule II. Illinois, a reduced practice state, still requires physician consultation for Schedule II opioids even with the FPA license.

Malpractice insurance. Several recent FPA and transition laws made coverage a condition of independent practice. Kansas, New Jersey, and Wisconsin all did.

Hospital privileges. Each facility’s bylaws decide who gets privileges. FPA doesn’t grant them.

Scope. You practice within your role and population focus. A family NP in a full practice state can’t open a psychiatric practice, and a PMHNP can’t run a primary care clinic.

Licensure in other states. FPA at home doesn’t travel. See a patient in a restricted state and that state’s collaboration rules apply to you.

Can I own a practice in a restricted state?

Yes, and thousands of NPs do. Practice authority and practice ownership are separate questions in every state. A Texas NP owns her PLLC outright and has a delegating physician for the clinical side. A Georgia NP owns the entity and files a protocol agreement. A Florida psych NP owns the practice under a supervising physician protocol. The physician doesn’t own any of it.

The difference is cost and dependency. In a restricted state you budget for the physician relationship as a monthly operating expense and you plan for what happens if that physician retires or quits. Our guide on finding a collaborating physician covers the services that do the matching, and our physician ownership myth guide explains why a supervising physician is never an owner.

Find your state in the table, count your hours, and decide whether to launch now with an agreement or wait for the threshold. A free call with the Prax team maps the timing in one conversation.

This guide is for general information only and isn’t legal, tax, or medical advice. State practice laws change, sometimes mid-year. Talk with a qualified professional about your situation.