Physician duties · NP · Kentucky
Signing for a Nurse Practitioner in Kentucky: what the physician takes on
The agreement is mandatory for the clinician, which makes its duties mandatory for you. Kentucky calls the instrument a Collaborative Agreement for Prescriptive Authority (CAPA).
Diagnosis and treatment are never physician-supervised in KY — KBN's own legal opinion holds APRNs practice independently and are individually accountable. Only prescribing is agreement-gated, via two separately-timed, separately-exitable agreements (nonscheduled drugs vs. controlled substances) rather than one combined threshold.
Independent practice requires: ≥4 years prescribing nonscheduled legend drugs under a CAPA-NS in good standing exempts the NP from further CAPA-NS requirements (KRS 314.042); ≥4 years prescribing controlled substances under a separate CAPA-CS in good standing exempts the NP from further CAPA-CS requirements.
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
No physical-presence or availability standard is codified for clinical practice — diagnosis/treatment requires no supervising physician relationship at all. The CAPA-NS/CAPA-CS agreements themselves are paperwork/prescribing constructs; no mile/minute radius or on-site standard for the collaborating physician was found in KRS 314.042 or 201 KAR 20:057.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
nonscheduled legend drugs, before 4 years under a CAPA-NS: Separate prescribing terms required · no controlled-substance authority
CAPA-NS required with a physician holding an active, unrestricted KY license in a same/similar specialty (KRS 314.042).
Schedule II–V controlled substances, before 4 years under a CAPA-CS: Separate prescribing terms required · controlled substances permitted
Requires individual DEA registration and KASPER (PDMP) master account enrollment in addition to a CAPA-CS with a physician in a same/similar specialty (KRS 314.042(11)).
after the applicable 4-year CAPA-NS/CAPA-CS threshold is met: Covered by the practice agreement · controlled substances permitted
The NP may notify KBN and discontinue the corresponding CAPA, prescribing independently within that drug category thereafter — the two categories are exited separately, not together.
Written agreement
Required
Branches by activity, not experience: an NP never needs any agreement to independently diagnose and treat patients. A written CAPA-NS is required only to prescribe nonscheduled legend drugs, and a separate CAPA-CS only to prescribe controlled substances — each can be independently discontinued after its own 4-year good-standing period (KRS 314.042).
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional LLC (KRS Ch. 275) or Professional Service Corporation (KRS Ch. 274) — 'nurses' are explicitly listed among the eligible professions in both chapters, so an NP may independently own a nursing-services PLLC/PSC. No physician ownership is required.
KY's PSC/PLLC statutes are commonly read to require single-profession ownership (KRS 274.015) rather than NC's/VA's explicit physician+APRN combination provisions — an NP-owned entity co-owned with a physician may not be a recognized single-PSC structure; treat as an open item pending KY-specific counsel.
What physicians charge for this role
Typical monthly compensation in Kentucky
$500 – $700
Estimate for one Nurse Practitioner. This state's proximity rules add a small premium.
About Kentucky's rules
KY's PSC/PLLC statutes (KRS Ch. 274, 275) are commonly read to restrict ownership to persons rendering the 'same or related' professional service — a physician generally cannot co-own a single PSC/PLLC with a PA or APRN, unlike NC/VA's explicit combination statutes. Secondary-sourced interpretation, not a confirmed ruling — verify before relying on it. Kentucky opted out of the federal Medicare CRNA supervision requirement in April 2012; facilities may still impose their own.
Other clinicians in Kentucky: see the state overview.