Physician duties · CNS · Florida
Signing for a Clinical Nurse Specialist in Florida: what the physician takes on
The agreement is mandatory for the clinician, which makes its duties mandatory for you. Florida does not name a specific instrument.
Not named in §464.0123's autonomous-practice carve-outs — no pathway to independence exists for CNS, unlike NP/CNM. No pending legislation targeting CNS autonomy was found, unlike the recurring CRNA fight; this appears to be a settled restriction rather than an actively contested one.
What you take on as the physician
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
No proximity requirement
§464.012(4)(d) contains no proximity language at all — the most generically-worded of the three APRN specialty subsections. Only the generic phone/communication-device availability language in the standard protocol template applies.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
As needed, in person or via telehealth
Not fixed by statute or rule — the Board of Nursing's official protocol template (floridasnursing.gov/forms/aprn-protocol-format.pdf) uses only generic language: parties 'share equally in the responsibility for reviewing treatment protocols as needed,' with the physician 'available by telephone or by other communication device when not physically available.' Actual cadence is whatever the individual protocol specifies.
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Resolved in a follow-up research pass: two Florida House staff bill analyses (HB 771, 2024; HB 301, 2026), both citing Rule 64B9-4.002, F.A.C., confirm 'Psychiatric Adult Clinical Nurse Specialist (CNS)' as one of the four certifications qualifying for 'psychiatric nurse' status — not itemized verbatim in the current codified rule text itself (which states only general meta-standards for recognized certifying boards), but corroborated by two independent official sources two years apart. A CNS certified in a non-psychiatric specialty does not qualify and remains subject to the general 7-day Schedule II cap.
Written agreement
Required
Unconditional — standard established protocol under §464.012(3)-(4)(d), same framework as other non-autonomous APRNs. §464.012(4)(d)'s CNS-scope language (assess/diagnose/plan/coordinate/evaluate) is more care-coordination/consultative than procedural, unlike CRNA/CNM's explicit ordering functions.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — Same framework as `np` — §400.9905(4)(g) applies identically.
Legal sources for these rules (4)
- Fla. Stat. § 464.012(4)(d) — APRN protocol, CNS-specific functions
- Fla. Stat. § 464.0123 — Autonomous practice by an APRN (no CNS carve-out)
- Fla. Stat. § 394.455 — 'psychiatric nurse' definition (cross-referenced for the unresolved carve-out question)
- Florida Board of Nursing — Official APRN Protocol Format template
What physicians charge for this role
Typical monthly compensation in Florida
$500 – $600
Estimate for one Clinical Nurse Specialist. This state's rules add a restrictive-tier premium.
About Florida's rules
Florida's 2020 autonomous-practice law (§464.0123, ≥3,000 supervised hours + coursework) creates a real independence pathway for NP and CNM — but excludes PMHNP, CRNA, and CNS entirely; CRNA autonomy bills have died three sessions running (2024-2026). Florida has no corporate-practice-of-medicine doctrine (secondary-source consensus) — entity ownership instead turns on the Health Care Clinic Act's §400.9905 exemption mechanics. Supervision ratio/chart-review/meeting-cadence are largely uncodified; PA's 10-supervisee cap is the exception.
Other clinicians in Florida: see the state overview.