Collaborating physician agreements for nurse practitioners and PAs
Caracola Medical is a physician-led, white-label telehealth medical group. Our physicians sign collaborating and supervising physician agreements for nurse practitioners and physician assistants. Available in every state that requires a collaborating or supervising physician. Our physicians are licensed in all 50 states and DC; we confirm your state's requirements on the discovery call. Founded by J. Chance Miller, MD and Stephanie Miller.
Last reviewed October 11, 2026 · Reviewed by J. Chance Miller, MD
We sign collaborating and supervising physician agreements
If your nurse practitioners or physician assistants need a physician on paper and in practice, our physicians can fill that role. We sign collaborating and supervising physician agreements for NPs and PAs, then do the work the agreement and the state require: protocol review, chart review, availability for consults and the documentation a board expects to see.
Available in every state that requires a collaborating or supervising physician. Our physicians are licensed in all 50 states and DC; we confirm your state's requirements on the discovery call. Every physician in our network is a licensed MD or DO.
- A licensed physician matched to your NPs and PAs in each state you serve
- A written agreement that covers what your state requires
- Chart review on the schedule the state or agreement sets
- A clear way for your clinicians to reach the physician with clinical questions
- Records of meetings, reviews and sign-offs, kept ready for a board inquiry
What is a collaborating physician agreement?
A collaborating physician agreement (also called a collaborative practice agreement, protocol agreement or, for PAs, a supervision or practice agreement) is a written document between a physician and a nurse practitioner or physician assistant. It sets out how the physician oversees or collaborates on the clinician's practice. Many states require one before an NP or PA may practice or prescribe.
Some states give NPs full practice authority and require no physician agreement at all. Others require one for every NP, or only for new NPs until they log a set number of supervised hours, or only for prescribing. PA rules follow their own path in each state.
What a collaborating physician agreement typically covers
| Term | What it sets |
|---|---|
| Scope of practice | Which services, patients and settings the NP or PA covers. |
| Prescriptive authority | What the clinician may prescribe, including any limits on controlled substances. |
| Chart review | How many charts the physician reviews and how often. |
| Meetings and availability | How often the physician and clinician meet, and how the physician can be reached. |
| Protocols | The clinical protocols or standing orders the clinician follows. |
| Practice sites | Where the clinician practices, which matters in states with distance or site limits. |
| Term and termination | How long the agreement runs and how either side ends it, including board notice. |
Fees for collaborating physicians vary with the state, how much chart review is required, whether controlled substances are involved and how many clinicians one physician covers. We discuss fees on the discovery call; we do not publish prices.
State rules: Florida, Texas and Georgia
These three states are among the most searched. The summaries below explain how each state's rules generally work. They are general information, not legal advice, and state rules change, so check the current rules with the state board before you rely on them.
Florida. Florida nurse practitioners (APRNs) generally practice under a written protocol with a supervising physician, filed with the Board of Nursing. Florida also lets some APRNs practice autonomously in primary care once they meet the state's supervised-practice hours and register with the board. PAs practice under a supervising physician, and Florida limits how many PAs one physician may supervise.
Texas. Texas NPs and PAs need a prescriptive authority agreement with a delegating physician before they prescribe. The agreement sets meetings and chart review, and Texas caps how many NPs and PAs one physician may delegate prescriptive authority to.
Georgia. Georgia NPs practice under a nurse protocol agreement with a delegating physician, filed with the Georgia Composite Medical Board. PAs need a supervising physician and a board-approved practice arrangement. Georgia limits how many clinicians one physician may oversee and has rules on the physician's availability to the clinician.
Florida, Texas and Georgia are examples; the service covers every state that requires a collaborating or supervising physician. These summaries are general information, not legal advice. Our compliance approach explains how state rules shape our protocols.
Who this is for
NP-led clinics
Independent nurse practitioner practices that need a collaborating physician to open or stay compliant.
Telehealth brands
Teams that staff NPs and PAs and need physician agreements in each state they serve.
Med spas and IV clinics
Aesthetic and wellness businesses where NPs or PAs treat patients under physician oversight.
Growing teams
Practices adding states that need a physician lined up before clinicians see patients there.
Ready to talk? Request a discovery call; we reply within 1 business day. Need more than an agreement? See our medical director services or all services.
Frequently asked questions
Does Caracola Medical sign collaborating physician agreements for nurse practitioners?
Yes. Our physicians sign collaborating and supervising physician agreements for nurse practitioners and physician assistants. Available in every state that requires a collaborating or supervising physician. Our physicians are licensed in all 50 states and DC; we confirm your state's requirements on the discovery call.
Do you provide supervising physicians for physician assistants?
Yes. The same service covers PAs. The agreement follows the PA rules in your state.
Which states do you cover?
Every state that requires a collaborating or supervising physician. Our physicians are licensed in all 50 states and DC; we confirm your state's requirements on the discovery call.
How much does a collaborating physician cost?
Fees vary with the state, the amount of chart review, whether controlled substances are involved and how many clinicians are covered. We discuss pricing on the discovery call.
Can the collaborating physician work remotely?
Often, yes, where the state allows it. Some states set distance, site or in-person meeting rules; those are handled case by case, and we tell you up front.
Is a collaborating physician the same as a medical director?
Not exactly. A collaborating or supervising physician fills the oversight role a state requires for an NP or PA. A medical director takes clinical responsibility for a practice's protocols and care. One physician can sometimes hold both roles.
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