Texas NP practice: delegation, agreements and your preceptors

The rule in brief

The Texas Board of Nursing states in its APRN practice FAQ that APRNs do not hold full practice authority in Texas. Their scope can reach medical diagnosis and prescribing, but only when a physician properly delegates it, and the BON says the medical aspects of care require a collaborative relationship and practice agreement with a physician. The governing text sits in 22 TAC Chapter 222 and Chapter 157 of the Texas Occupations Code.

Section 222.5(a) calls the prescriptive authority agreement the tool a physician uses to hand an APRN the power to order and prescribe medicines and devices. Most of what follows on this page flows from that one signed document, which an outpatient NP preceptor in Texas holds with a named physician.

Meetings, yearly review and the physician's cap

The periodic meetings must be documented and held at least monthly, in a way the physician and APRN agree on (§222.5(d)). According to the BON, House Bill 278 of 2019 ended the face-to-face requirement, so for agreements signed on or after September 1, 2019 the monthly meeting can happen by telecommunication.

The full agreement is reviewed, dated and re-signed at least once a year, and the parties must produce it to the BON, the Texas Medical Board or the Texas Physician Assistant Board by the third business day after one of them asks (§222.5(k)).

The BON's FAQ also caps delegation. In most settings one physician may delegate to at most seven full-time-equivalent APRNs and PAs combined, and no waiver is available. Facility-based hospital practices and practices serving medically underserved populations have no numeric cap. Each prescription carries the delegating physician's name, address and phone number, plus a DEA number for controlled substances, under Occupations Code §157.056 as the BON describes it.

What delegation means for who can precept you

The FNP syllabi at UTRGV name three preceptor types: NP, PA and MD/DO. In a Texas practice, an NP preceptor always prescribes under a delegating physician, and that physician is also an eligible preceptor type for the FNP courses, which is worth knowing when you propose a practice to faculty. NURS 6347 is narrower and asks for master's-prepared NPs at two sites.

For the PMHNP courses, UTRGV sets the credential: either a psychiatrist holding ABPN board certification with over a year of post-residency practice, or an ANCC-certified PMHNP. DNP project preceptors are physicians and/or DNP-prepared APRNs. Preceptor requirements lists every rule, and Texas BON preceptor rules covers the state's definition of a qualified preceptor.

One detail shapes how we vet NPs: an RN practicing on interim approval as an APRN has no prescriptive authority (§222.2(a)). We look for preceptors with full APRN licensure and a current agreement, and we ask which drug categories the agreement covers, so the prescribing you learn from matches your course.

PMHNP students outside Texas

Texas's delegation model is one of several in the country. PMHNP certificate students train in their home state, where physician involvement can look quite different, and one assignment in the Spring 2026 NURS 6620 syllabus has students examine the level of physician oversight their state sets. PMHNP clinicals outside Texas covers the state side. In any state, the clinical faculty member assigned to you must clear the site before your hours start.

Wherever you live, we match PMHNP preceptors to the rules of that state and to UTRGV's board-certification requirement, and for Texas residents we confirm the preceptor's credential and prescribing arrangement before you commit. Tell us your course, your state and your start term, and we reply with a matching plan.