Texas State Policy Fact Sheet


American Association of Nurse Practitioners - Texas State Policy

Nurse Practice Act: V.T.C.A., Occupations Code Chapter 301

Regulatory Structure: Restricted Practice

State law restricts patient access to nurse practitioner (NP) care. State licensure law constrains NP practice by requiring physician delegation and supervision for at least one element of NP practice.
Tex. Occ. Code Ann. § 301.152

Regulatory Agency

NP practice is regulated by the Board of Nursing (BON).
Tex. Occ. Code Ann. § 301.152

Licensure Requirements

Requirements include an RN license, a graduate degree in an NP role and national certification.
22 TAC § 221.4

Schedule II Controlled Substance Prescriptive Authority

NP Schedule II prescriptive authority is authorized in select settings and practice types.
Tex. Occ. Code Ann. § 157.0511

Continuing Education (CE)*

CE requirements can be met by complying with national certification or by meeting specific Board of Nursing requirements.
22 TAC § 221.8

Medical Staff Membership**

Medical staff composition is determined by the facility’s governing body.
V.T.C.A., Health & Safety Code § 241.101

Primary Care Providers

NPs are defined in law as Primary Care Providers in select instances.
V.T.C.A. Health & Safety Code § 62.1551

Supervisory Agreement Ratio***

One physician may enter into supervisory agreements with no more than seven NPs or other Advanced Practice Registered Nurses or Physician Assistants.
Tex. Occ. Code Ann. § 157.0512

Signature Recognition on Items of Patient Care

  • Physical Therapy: NPs are authorized to refer to physical therapy.
    22 TAC § 322.1
  • Parking Permits: NPs are authorized to provide proof of disability for disabled parking permits.
    V.T.C.A., Transportation Code § 681.003
  • DNR: NPs are not currently authorized to sign Do Not Resuscitate orders.
  • Death Certificates: NPs are authorized to sign death certificates in certain circumstances.
    V.T.C.A., Health & Safety Code § 166.081
  • Provider Orders for Life Sustaining Treatment (POLST): Texas’ POLST program is developing.
    V.T.C.A., Health & Safety Code § 193.005

*Contact hours in specific topics may be required. Please contact your state Board of Nursing for current information.
**Medical Staff Membership refers to governing and voting privileges and is not reflective of clinical or admitting privileges within institutions.
***Exemptions may be available. Please consult full law for guidance.
DISCLAIMER: The material contained in this fact sheet is offered as information only and not as practice, financial, accounting, legal or other professional advice.
Correspondents must contact their own professional advisors for such advice.

Updated December 20, 2018

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