Missouri's rules on NP clinicals and who can precept you

Missouri's APRN rule, and what it leaves out

The Missouri State Board of Nursing sets its APRN requirements in 20 CSR 2200-4.100, in effect since May 30, 2024. For education, the rule asks an APRN program to provide at least 500 faculty-supervised clinical hours, a floor in place since January 1, 2009. Maryville's current curriculum sits above it: since Spring 2024, each NP concentration has required 750 clinical hours.

Research found no Missouri Board rule that governs APRN student placements, whether the school is in Missouri or elsewhere, and none that caps how many APRN students one preceptor may supervise. Neither the APRN rule nor the collaborative practice rule mentions students at all.

So the Board is not the one approving your preceptor or site; Maryville and the facility are. The Board's definitions matter in a narrower place: the prescribing record you may need later.

What Missouri calls a qualified preceptor

The same rule gives "qualified preceptor" a specific meaning tied to prescribing. Under 20 CSR 2200-4.100, a qualified preceptor is one of two people:

• an APRN with a current, unrestricted RN and APRN license, whose scope includes prescribing and who has met the requirements for prescriptive authority;
• a licensed MD or DO with unrestricted prescriptive authority.

Physician assistants are not in that definition. The rule also defines "preceptorial experience" as a designated part of a formal education program, carried out in a healthcare setting and involving direct patient care or client management. A clinical practicum inside a formal NP program is the plain example, which is why the identity and license of the person supervising your prescribing matter under this rule.

Why the definition matters: controlled-substance authority

The definition does its work in section (3) of the rule, which covers authority to prescribe controlled substances. A Missouri APRN seeking that authority needs:

• a Board form documenting 300 or more clock hours of preceptorial experience, with a qualified preceptor, in prescribing drugs, medicines and therapeutic devices;
• an advanced pharmacology course;
• 1,000 post-graduation hours of APRN practice;
• that authority delegated in a collaborative practice arrangement.

Read together, the definition and section (3) suggest that prescribing hours logged under a physician assistant would not count toward the 300. That is an inference from the rule text, not a Board ruling, and the same reasoning applies to hours with a clinician who does not prescribe.

If you expect to practice in Missouri, keep your own record of who supervised your prescribing hours and what license they held, and get the current documentation form from the Missouri State Board of Nursing.

Collaborative practice: the arrangement behind every Missouri NP

Missouri is a restricted-practice state in the AANP's classification. Every NP there practices, for their entire career, under a collaborative practice arrangement (CPA) with a physician, and the arrangement limits ratios, sets chart review and restricts controlled substances. A Missouri NP preceptor therefore brings a physician relationship into your rotation.

The main terms are in 20 CSR 2200-4.200, the Board of Nursing's CPA rule, effective July 30, 2024:

• A CPA can be written agreements, protocols both parties agree on, or standing orders.
• The collaborating physician must be available for consultation at all times, in person or by telecommunication.
• When the APRN is diagnosing and beginning treatment of patients who are acutely or chronically ill, the physician has to be physically present at least every two weeks and review no less than 10% of the APRN's services, or 20% where controlled substances are involved.
• The APRN can be delegated authority to prescribe Schedule II hydrocodone and Schedules III–V.

A companion rule from the Board of Registration for the Healing Arts, 20 CSR 2150-5.100, requires the collaborating physician to report each CPA to that board within 30 days of any change and at every license renewal.

What the statute adds, and what to confirm

The collaborative practice statute is RSMo 334.104. Its page on the Missouri Revisor's site could not be loaded during research, so the points below come from search-result excerpts and third-party summaries. Treat them as leads to confirm at revisor.mo.gov, not settled text.

• One physician's collaborations are capped at six full-time-equivalent APRNs, physician assistants and assistant physicians in total (search excerpt of the Revisor page).
• Before an APRN practices where the physician is not continuously present, the physician must document at least a one-month period in which the APRN practiced with the physician continuously present (excerpts of Justia's 2011–2024 versions, which agree).
• A third-party 2026 guide says the old 75-mile proximity limit was removed in 2024, leaving a standard that the physician must not be so far away that collaboration is impeded.

None of these limits mentions students. They shape your preceptor's own practice, such as how many clinicians their physician already works with.

Who can precept a Maryville student in Missouri

Maryville's rule decides whether your Exxat request can be approved. Missouri's definition only bears on the prescribing record you may need later. Here they are side by side.

A board-certified NP, MD or DO with a year in practice and prescribing authority meets both. Maryville's exclusions still sit on top: no relatives, no one in your reporting line, no direct work colleague and not your own healthcare provider. The full rule set is on Maryville preceptor requirements, and the route for an uncertified preceptor is the Preceptor Exception Form.

PMHNP students should plan the split. Maryville's 2026 guidance opens PMHNP precepting to LCSWs and to psychologists with a PsychD or PhD, but hours with them would not come from a Missouri qualified preceptor, so keep your prescribing hours with a psychiatric NP or physician. See PMHNP preceptors.

At a Missouri site: the CPA, the contract and your license

Two practical points follow, both inferences from the rules rather than stated policy. You work inside your preceptor's CPA protocols, because the NP you train with practices under them. And extra conditions such as orientation, screening or ID badges come from the facility and its contract with Maryville, not from the Board.

Maryville's side of that contract is its MOU or the site's own agreement, and the site is judged separately from the preceptor; see site approval. Health systems with their own onboarding go through the Onboarding Request Form.

Your RN license, under Maryville's rule, must be unencumbered and valid in the state of your clinical site. For Missouri, a multistate license works: NCSBN's implementation table dates the state's compact to January 19, 2018. The state's board, compact status and major systems are summarized on the Missouri page.

Why Missouri students choose us

Missouri is Maryville's home state, and we know its rules in detail. When a placement advisor looks for a Missouri preceptor for you, the points on this page are checked before anything reaches Maryville: board certification, years in practice, prescribing authority and any tie to you. If you plan to practice in Missouri, we favor preceptors who also count as Missouri qualified preceptors, so your prescribing hours build toward controlled-substance authority. For PMHNP students, the search starts with a psychiatric prescriber.

Maryville approves every preceptor and site, and the candidates we bring it already fit its rule, and Missouri's definition where that matters to you. If a Missouri preceptor drops out mid-term, we're on call to find another. For a second pair of eyes on a candidate you've found, send us their credential and your track.