Physician duties · CNS · Massachusetts

Signing for a Clinical Nurse Specialist in Massachusetts: what the physician takes on

No agreement is required, so the terms are whatever you both negotiate. Clinical Nurse Specialists practice independently in Massachusetts, so any agreement is voluntary.

Practice authorityIndependent practice
Written agreementNo agreement required
What Massachusetts calls itNo instrument required
Research date2026-09-03

General CNSs are not among the APRN categories granted prescriptive authority in MA (only the psychiatric specialty, tracked here as 'pmhnp,' qualifies under M.G.L. c.94C §7). Without prescribing, MA's regs impose no supervising-physician requirement on general CNS practice.

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

Not codified — left to the agreement

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

Covered by the practice agreement · no controlled-substance authority

244 CMR 4.07 lists CRNA, CNM, CNP, and PNMHCS (psychiatric CNS) as the APRN categories authorized for prescriptive practice under M.G.L. c. 94C §7 — general CNS is not included and has no DEA/DPH controlled-substance registration pathway.

Written agreement

Not required

Unconditional — general (non-psychiatric) CNS scope in MA never includes prescribing, so there is no branch or threshold that would trigger a supervision/agreement requirement, unlike the psychiatric specialty tracked separately as `pmhnp`.

Practice ownership (corporate practice of medicine)

Licensee-only ownership required — Same open item as the general `np` entry — Professional Corporation under M.G.L. c. 156A; nurse-owned PC/PLLC eligibility for CNS-delivered care was not confirmed from primary text this pass.

Legal sources for these rules (2)

What physicians charge for this role

Typical monthly compensation in Massachusetts

$500$600

Estimate for one Clinical Nurse Specialist. Standard-tier state.

About Massachusetts's rules

Full practice authority (Acts 2020, c. 260, §36; 244 CMR 4.00) let NPs, PMHNPs, and CNMs practice independently in MA — CNMs immediately, NPs/PMHNPs after a Board-attested transition (244 CMR 4.07). PAs and CRNAs have no independent-practice pathway. MA's professional-corporation ownership rules (M.G.L. c. 156A) are notably strict; this file could not independently re-verify APRN/PA-specific PLLC eligibility this pass — treat CPOM entries as open items.

Other clinicians in Massachusetts: see the state overview.