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Basic principles to consider when opening a nurse practitioner-owned practice in Texas

Watson, Michael APRN, FNP-BC (Family Nurse Practitioner, Doctor of Nursing Practice Student)1

Journal of the American Association of Nurse Practitioners: December 2015 - Volume 27 - Issue 12 - p 683–689
doi: 10.1002/2327-6924.12274

Purpose: Advanced Practice Registered Nurse (APRN)-owned clinics in Texas are becoming more common and because of the success of these early clinics, more APRNs are considering opening their own practice; but Texas remains one of the most restrictive states for APRN practice and many questions remain. What are the regulations about physician delegation? Will you get reimbursed from insurance companies and at what rates? Can you be a primary care provider (PCP)?

Data sources: Changes enacted after the adoption of Senate Bill 406 improved the opportunities for APRNs in Texas yet several requirements must be met and early consultation with a lawyer and accountant can facilitate the initial business setup. The Prescriptive Authority Agreement simplified the delegation requirements and allows the APRN increased flexibility in obtaining and consulting with a delegating physician. Becoming credentialed as a PCP with private insurance companies is often complicated; however, utilizing the Council for Affordable Quality Healthcare's Universal Provider Data source for initial credentialing can facilitate this.

Conclusions and implication for practice: Although this article does not discuss the financial implications of opening a practice, it does cover many aspects including legislative and regulatory requirements for practice, credentialing process and challenges, business structure, and tax implications.

1 College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas,

Received 19 January 2015; Accepted 25 March 2015

Correspondence Michael Watson, APRN, FNP-BC, E-mail:

© 2015 American Association of Nurse Practitioners
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