Overview
A collaboration agreement is a signed agreement between a medical director and a nurse practitioner (NP) or physician assistant (PA) that establishes the NP's or PA's prescribing authority and defines how the two work together at the medspa. Sign a collaboration agreement whenever a medical director oversees a provider who holds an NP or PA license. This is in addition to the medical director's standard oversight agreement.
This guide is for medspa owners and clinical providers, particularly NPs and PAs, who work with, or are preparing to work with, a collaborating or supervising physician. It explains what collaboration agreements are, when state law may require one, and the general steps for putting one in place. Medical directors and operations team members can also use this guide to understand their role in the process.
Why a collaboration agreement matters
A collaboration agreement matters because it gives an NP or PA the ability to operate more independently by documenting, in writing, how much oversight the medical director provides and under what conditions. Without it, an NP or PA may lack clearly documented prescribing authority, which can create compliance gaps and slow down patient care.
Who signs a collaboration agreement
The medical director and the NP or PA sign the collaboration agreement together, alongside the medical director's standard oversight agreement. When a medical director oversees an NP or PA, the medical director also takes on the role of Collaborating Physician for that provider
Signing a collaboration agreement is standard practice for NP and PA providers at Moxie. In some states, it's also a legal requirement before an NP or PA can prescribe. If the state provides a required form, the NP or PA and the collaborating physician generally complete that form together.
❗ Important — Collaboration agreement requirements vary by state. Confirm your state's specific supervision and collaboration rules before finalizing the terms of the agreement.
What a collaboration agreement establishes
A collaboration agreement covers the following:
Roles: Defines how the medical director supervises and supports the NP or PA in patient care.
Legal requirements: Confirms that the NP or PA practices within their state's specific rules for NPs and PAs.
Protocols: Lists the procedures and standards the NP or PA follows, especially for treatments performed at the medspa.
Liability: Clarifies who is responsible if something goes wrong and confirms that both parties carry the right insurance.
Communication: Defines how and when the NP or PA consults with the medical director on patient care decisions.
Quality of care: Sets clear expectations that help ensure patients receive safe, consistent care.
Example
A medspa owner who is an NP hires a medical director for clinical oversight. Because the owner holds an NP license rather than an MD license, the medical director also becomes the Collaborating Physician and signs a collaboration agreement with the NP. The agreement outlines which treatments the NP can perform independently, when the NP must consult the medical director, and how prescribing authority is delegated.