Learn more about prescriptive authority requirements and practice guidelines

Prescriptive authority is the ability for an APRN (except a non-psychiatric CNS) to issue written or oral prescriptions or medication orders.

What are prescriptive guidelines?

Guidelines are written instructions and procedures which describe the methods that APRNs, who require supervised prescriptive practice, are to follow when managing medications.  The guidelines specify the instances when referral or consultation with the Qualified Healthcare Professional (QHP) are required for appropriate medication management.

When an APRN registers with DCP as an APRN with supervised prescriptive practice, they are required to sign an attestation that they have a QHP supervising their practice and have developed mutually agreed upon guidelines.

The Board provides an Audit Tool for Compliance with the Regulations at 244 CMR 4.00 and to help with guideline development. 

  • Certified nurse midwives (CNMs) are not required to have guidelines or supervision.
  • Clinical nurse specialists (CNSs) are not authorized by statute to register for prescriptive practice.

Contact the DCP at (617) 973-0800 or dcp.dph@state.ma.us for more information regarding MCSR requirements.  


Additional Resources

Education requirements for prescribers

To apply for prescriptive authority from MA Controlled Substance Registration (MCSR) and to renew your APRN authorization every two years, all prescribers must complete education relative to:

  • Effective pain management
  • The risks of abuse and addiction associated with opioid medication
  • Identification of patients at risk for substance use disorders
  • Counseling patients about the side effects, addictive nature and proper storage and disposal of prescription medications
  • Appropriate prescription quantities for prescription medications that have an increased risk of abuse
  • Opioid antagonists, overdose prevention treatments and instances in which a patient may be advised on both the use of and ways to access opioid antagonists and overdose prevention treatments.

These requirements are in accordance to Massachusetts state law M.G.L. c. 94C s.18(e). Please note that M.G.L. c. 94C s.18(e) does not specify a minimum number of contact hours to comply with this education requirement.

Nurse prescribers may choose any program that meets the required content and is consistent with the Board’s continuing education requirements, such as the free course work at SCOPE of Pain or National Institute on Drug Abuse (NIDA).

Prescriptive guidelines for practicing in more than one setting

  • When an APRN registers with the Department of Public Health Drug Control Program (DCP) for prescriptive practice as an APRN with independent prescriptive practice authority, and they are responsible for ordering or storing controlled substances, they need a MA Controlled Substance Registration (MCSR) at each site address. Please refer to the DCP requirements in 105 CMR 700.00 and 105 CMR 721.

Contact the DCP at (617) 973-0800 or dcp.dph@state.ma.us for more information regarding MCSR requirements.

Requirement to register for and use the Prescription Monitoring Program (PMP)

The PMP uses a computer-based, Electronic Data Transfer (EDT) system to collect prescription data from Massachusetts community hospitals, outpatient and clinic pharmacies, and out-of-state mail order pharmacies that deliver to patients in Massachusetts. PMP is a tool that supports safe prescribing and dispensing and assists in addressing prescription drug misuse and abuse.

You must register for and use Massachusetts Prescription Awareness Tool (MassPAT) online.

Contact   for Learn more about prescriptive authority requirements and practice guidelines


Board of Registration in Nursing 617-973-0984
Board of Registration in Nursing - SARP 617-887-8786


250 Washington Street, Boston, MA 02108

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