APRN General Information


2018 Collaborative Practice Changes Impacting APRNs

Pursuant to the passing of SB 718 this past legislative session, a change to the collaborative practice statute, 334.104 RSMo, has been passed and went into effect August 28, 2018:

A collaborating physician or supervising physician shall not enter into a collaborative practice arrangement or supervision agreement with more than [three] six full-time equivalent advanced practice registered nurses, full-time equivalent licensed physician assistants, or full-time equivalent assistant physicians, or any combination thereof. This limitation shall not apply to collaborative arrangements of hospital employees providing inpatient care service in hospitals as defined in chapter 197 or population-based public health services as defined by 20 CSR 2150-5.100 as of April 30, 2008, or to a certified registered nurse anesthetist providing anesthesia services under the supervision of an anesthesiologist or other physician, dentist, or podiatrist who is immediately available if needed as set out in subsection 7 of this section.

This change in practice is in effect even though the collaborative practice regulations have not been changed. Statute rules over regulation.


Changes to Collaborative Practice Regulations - 20 CSR 2200-4.200

On April 26, 2018 an emergency rule went into effect increasing the mileage for collaborative practice agreements from thirty (30) and fifty (50) miles to seventy-five (75) miles. This emergency rule is set to expire February 5, 2019. At the same time that the emergency rule was filed, the amended rule was filed to permanently expand the mileage. The amended rule went into effect October 30, 2018.