Signing for a Nurse Practitioner in Georgia: what the physician takes on

Within 50 miles

O.C.G.A. § 43-34-25: the delegating physician must hold an active Georgia medical license, practice medicine in Georgia, and have a principal place of practice either within Georgia or, if outside, within 50 miles of the location where the protocol is utilized (defined as the patient's physical location at time of service — applies even to telehealth encounters per GCMB guidance). This rule was NOT removed by the 2023-2024 reform, contrary to a common assumption; it is a deficiency that cannot be cured on an incomplete protocol submission.

Up to 8 at a time (combined across provider types)

O.C.G.A. § 43-34-25(g)/(g.1)/(g.2), as amended by H.B. 1046 (eff. 7/1/2024): a delegating physician is capped at a flat 'combined equivalent of eight' APRN nurse protocol agreements and PA job descriptions together — for BOTH entering agreements and actively supervising, confirmed directly against GCMB's current guidance — raised from a prior 4-APRN cap, with exceptions for hospitals, colleges/universities, public health departments, county boards of health, free clinics, and birthing centers. A Cornell LII mirror still showing 'enter 8/actively supervise 4' language reflects the pre-2024 (2019-vintage) rule, not a surviving distinction.

standard (non-accredited-facility) nurse protocol agreement: 10% of charts · Annually · countersignature required

Ga. Comp. R. & Regs. 360-32-.02: delegating physician must review and sign 100% of records for patients who received a controlled-substance prescription — confirmed QUARTERLY, not a one-time pass at prescription — and 100% of records where an adverse outcome occurred (within 30 days of discovery); 10% of all OTHER patient records, reviewed at least annually (coded here as the general 10%/annual figure — the three distinct review tracks aren't separately representable in this schema's single-percentage/frequency field).

accredited-facility nurse protocol agreement (reduced track): 10% of charts · Quarterly

Facilities meeting accreditation/evidence-based-guideline standards may use a flat 10%-of-all-records review, but must hold and document quarterly clinical collaboration meetings (telephone, in-person, or on-site — modality flexible) in exchange.

accredited-facility nurse protocol agreement (reduced chart-review track): Quarterly, in person or via telehealth

See chartReview above — this is the trade-off for the reduced 10% review standard. No universal meeting-frequency requirement was found for the standard (non-accredited) track beyond the annual protocol review/renewal itself.

Covered by the practice agreement · controlled substances permitted

Requires a protocol addendum and a DEA registration change — APRN DEA registrations otherwise only permit Schedule III-V.

Licensee-only ownership required — Same framework as `pa` — O.C.G.A. § 14-7-5 requires PC shareholders to be licensed in, and actively practicing, the profession the entity is organized to deliver. Confirmed directly: § 14-7-5's eligible-profession list explicitly names 'registered professional nursing' as its own listed profession, separate from medicine — an NP may own an entity organized to deliver nursing-scope services, but not a medicine-practicing PC/PLLC.