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The Massachusetts Board of Registration in Nursing (800-414-0168 or 617-973-0900 or email) grants authorization to registered nurses who qualify to work in expanded roles as advanced practice registered nurses (APRN). The board recognizes four general categories under the APRN umbrella:
- Nurse practitioner (RN/NP)
- Nurse midwife (RN/NM)
- Nurse anesthetist (RN/NA)
- Psychiatric mental health clinical nurse specialist (RN/PC)
Before applying for APRN authorization, you must hold an active Massachusetts RN license.
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- If you have never held an RN license in Massachusetts or any other state, and graduated from a nursing school located within the United States, use the Application Process for RN Educated in the United States to apply for Massachusetts RN licensure.
- If you attended nursing school outside of the United States, use the Application Process for RN Educated Outside of the United States to apply for Massachusetts RN licensure.
- If you already hold an RN license in another state, use the MA Nursing by Reciprocity – Registered Nurses online process to obtain a Massachusetts RN license.
- If your Massachusetts RN license is currently expired, you can reinstate it online by following the Board’s renewal process.
Take the following steps to become an APRN authorized to practice in Massachusetts.
Step 1. Get Your Graduate Degree
You must complete a formal advanced nursing education program beyond the basic RN level to achieve APRN authorization in Massachusetts. A national accreditation body recognized by the Massachusetts Board of Registration in Nursing must have accredited the program.
Sacred Heart University’s CCNE-accredited online nursing programs include options for registered nurses at every level— from RN-BSN-MSN options for ADN- and diploma-prepared RNs, to post-bachelor’s MSN options, DNPs, and graduate certificates. Learn more about earning your advanced nursing degree online through Sacred Heart University without ever leaving Massachusetts.
Qualified Graduate Programs
Under Nursing Regulation 244 CMR 4.00, advanced practice registered nurse preparation programs must meet the following qualifications:
- Nurse Midwife: Completion of a formal education program recognized by the Board that is designed to prepare nurse midwives.
- Nurse Practitioner: completion of a formal education program for RNs that is approved by a national professional nurses accreditation body and recognized by the Board. The program must be at least one academic year long and be designed to prepare nurse practitioners.
- Psychiatric Mental Health Clinical Nurse Specialist: Completion of a formal education program for RNs approved by a national professional nurses accreditation body and recognized by the Board. The program must be at least one academic year long and be designed to prepare nurses to practice as psychiatric mental health clinical nurse specialists.
- Nurse Anesthetist: Completion of a formal education program that meets the standards of the Council on Accreditation of Nurse Anesthesia Programs and designed to prepare RNs to work as nurse anesthetists.
Course Requirements
The Massachusetts Board of Registration in Nursing requires all aspiring APRN to complete core APRN coursework:
- Advanced physical assessment
- Advanced pathophysiology
- Advanced pharmacology (at least 24 hours beyond that which is required for basic RN education)
Additional coursework you take will be specific to the scope of practice of the APRN category in which you seek authorization:
- Nurse Midwife:
- Assessment of women and infants’ health status including:
- Getting accurate health/medical histories of patients
- Performing physical exams
- Diagnosing health/developmental problems
- Establishing continuity of care with patients
- Instructing and counseling women and families
- Collaborating with other health care providers and agencies
- Managing normal pregnancies throughout labor, delivery and post partum period
- Infant growth and development
- Methods of contraception
- Acute chronic gynecologic illness
- Assessment of women and infants’ health status including:
- Nurse Practitioner:
- Assessment of health status of individuals and families including:
- Getting accurate health/medical histories of patients
- Performing physical exams
- Diagnosing health/developmental problems
- Treatment of patients with chronic/acute illness and disease
- Assessment of health status of individuals and families including:
- Psychiatric Mental Health Clinical Nurse Specialist:
- Delivery of mental health services:
- Evaluating mental health problems
- Diagnosing mental health problems
- Consulting with other providers regarding patient mental health
- Therapeutic procedures used to treat mental health problems
- Delivery of mental health services:
- Nurse Anesthetist:
- Preoperative evaluation of patients
- Selection of anesthetic agents
- Including and maintaining anesthesia
- Managing intraoperative pain relief
- Supporting life functions during administration of anesthesia, such as:
- Intratracheal intubation
- Monitoring blood loss and replacement
- Replacement of electrolytes as necessary
- Maintaining cardiovascular function
- Maintaining respiratory function
- Recognizing abnormal patient responses to anesthesia and knowing what corrective action to take
- Professional observation and resuscitative care during postoperative period
- Medication prescribing for perioperative care
- Ordering of tests and therapeutics for perioperative care
Prescriptive Authority
Prescriptive authority (or the authority to issue written or oral prescriptions for drugs or substances) is an option available to qualified APRNs in Massachusetts. To obtain initial prescriptive authority, and for renewal of prescriptive authority thereafter, you must have completed education in the following areas:
- Effective pain management
- Identifying patients at high risk for substance abuse
- Counseling patients about side effects, addictive properties, and storage and disposal of prescription medications
The Massachusetts Board of Registration in Nursing does not specify a minimum number of contact hours for these courses.
Specialization
The Massachusetts Board of Registration in Nursing authorizes APRNs by category, not by specialization within the category. (Categories include nurse practitioner, nurse midwife, psychiatric mental health nurse practitioner, and nurse anesthetist). However, specialization is available within your advanced nursing education program and may be beneficial to your future APRN career options. Examples of specialized tracks include nurse leadership, nurse administration, business administration combined with nursing, and nurse education. Other areas of specialization dealing with the specific patient populations with which you may work, such as pediatric or geriatric, may also be beneficial to complete at this time.
Step 2. Earn Your National Certification
A requirement for obtaining authorization to practice in one of the four expanded APRN roles is national certification.
Every national certification agency has its own education and experiential minimums required to be eligible to sit for their national certification exam.
Certification Programs
The Massachusetts Board of Registration in Nursing grants authorization for APRNs to practice in the following expanded roles:
- Nurse practitioner (RN/NP)
- Nurse midwife(RN/NM)
- Nurse anesthetist (RN/NA)
- Psychiatric mental health clinical nurse specialist (RN/PC)
The Massachusetts Board of Registration in Nursing recognizes the following national certifying agencies for the certification of qualified APRNs in the state:
Nurse practitioner (RN/NP):
- AANP (American Academy of Nurse Practitioners)
- ANCC (American Nurses Credentialing Center)
- NCC (National Certification Corporation)
- PNCB (Pediatric Nurse Certification Board)
- AACN Certification Corporation (American Association of Critical Care Nurses)
Psychiatric mental health clinical nurse specialist (RN/PC):
Nurse anesthetist (RN/NA):
Nurse midwife (RN/NM):
You must become nationally certified within the APRN authorization category you seek before moving forward in the Massachusetts APRN authorization process. Contact the appropriate agency above for further information.
Step 3. Apply for Your APRN Authorization
Professional Credential Services, Inc. (PCS) has been contracted by the Massachusetts Board of Registration in Nursing to facilitate the application process for new licensees and those seeking APRN authorization.
Application and Supporting Documentation
Download and complete the Advanced Practice Registered Nurse Authorization Application. Along with the application:
- Enclose a copy of your current, valid Massachusetts RN license
- Enclose a copy of your current national certification
- Have your APRN education program send an official transcript directly to PCS
- If you answered yes to any questions on the Good Moral Character portion of the application, consult the Documentation Required for Determination of Good Moral Character (see below) and enclose the proper documentation needed.
- Attach the authorization fee of $150 by credit card form or money order payable to PCS
If you are licensed as an RN in a state other than Massachusetts and your state does not use the NURSYS verification system, complete the license verification form (included on page 6 of the application packet). Submit this form directly to the Board of Nursing in the state in which you hold an RN license. The Board must be instructed to return the form directly to PCS. State boards of nursing that are currently not on the NURSYS verification system are California, Kansas, Oklahoma, Illinois, Alabama, Georgia, Pennsylvania, Hawaii, and Connecticut
If the state in which you hold an RN license is on the NURSYS verification system, go to www.nursys.com and complete the instructions to have your RN license verified. Currently, 46 state boards of nursing are on the NURSYS system.
If you hold APRN authorization in another state, you must have that state’s board of nursing verify this authorization. Complete the authorization verification form (included on Page 7 of the application packet). Contact your state board of nursing to determine the fee they charge for this service, and send that fee along with the authorization verification form to your state board of nursing. Instruct them to return results directly to PCS.
Mail all of the above to Professional Credential Services, Inc., ATTN: MA Nurse Coordinator, P.O. Box 198788, Nashville, TN 37219. Allow three business days for PCS to review and approve your application. Your letter of authorization will be sent to you via postal mail within one week of PCS approval. At the same time, PCS will send electronic notification to the Massachusetts Board of Registration in Nursing. You may check for your license verification online prior to receiving your APRN letter of authorization.
Determination of Good Moral Character
In lieu of a criminal history background check, the APRN authorization application has a six-question section entitled “Determination of Good Moral Character.” These questions relate to disciplinary actions and criminal convictions against you. If you answer yes to any of these questions, additional documentation must accompany your APRN authorization application. A list of required documentation for various “yes” answers may be found here.
Based upon your answers, you may be asked to complete a Criminal Offender Record Information (CORI) form, authorizing the Massachusetts Department of Criminal Justice Information Services to conduct a criminal background investigation. You must answer each question truthfully, as lying on the application will result in you being excluded from being authorized to practice as a nurse for five years. Only conviction for violent crimes will permanently exclude you from licensure in Massachusetts. If you have been convicted of a crime within the past five years, you may be temporarily excluded from licensure. More information on the Determination of Good Moral Character and its consequences may be found here.
Practice and Prescriptive Guidelines/Collaborative Agreement
As an authorized APRN in Massachusetts, you must practice in accordance with written guidelines. Guidelines must be created in collaboration with a physician recognized as an expert within your area of practice, and then approved by the Board of Nursing. The following information must be included within your guidelines:
- The nature and scope of your practice
- The circumstances under which you will require consultation with a physician
- Established procedures you will use to treat certain common medical conditions
- How you will manage emergencies
If you also have prescriptive authority, you must include Guidelines for Prescriptive Practice:
- How your practice will be reviewed and documented at least every three months by your supervising physician
- How frequently the physician will review your initial prescriptions
- Protocols for initiating IV therapy
- Protocols for initiating Schedule II drugs
- How you will review Schedule II prescriptions with your supervising physician within 96 hours of their initiation
Guidelines must be reviewed and signed by all parties every two years. You must have your written guidelines handy to produce upon request.
The nursing and medical leadership of the institution in which you work must approve your guidelines. If you work in a setting with no such leadership, you must submit the original, signed and dated practice and prescriptive guidelines to the Board for audit and approval. When your guidelines are renewed every two years, the same approval process applies.
Prescriptive Authority
After authorization as an APRN in Massachusetts, you may seek prescriptive authority. To do so, make sure your prescriptive guidelines are in place. Then submit the application for Massachusetts Controlled Substance Registration (MCSR) at the Massachusetts Department of Public Health- Drug Control Program (DPH-DCP). If you plan to prescribe controlled substances in Schedules II-V, you also need a Drug Enforcement Agency (DEA) number. After you have your state CSR number, apply online for your DEA number.
Step 4. Renewing Your Authorization
Your APRN authorization and RN license expire on your birthday in even numbered years. To maintain APRN authorization, you must maintain a current, valid Massachusetts RN license, maintain national certification, and meet all continuing education requirements.
Approximately 90 days before your license and authorization is set to expire, you will receive a renewal reminder by mail. This will include information on renewing online or by mail, if desired. You must pay the $180 APRN authorization renewal fee and $120 renewal fee for your RN license by check or money order payable to the Commonwealth of Massachusetts. Write your license number and your name on the front of your check or money order.
If you no longer wish to hold APRN authorization, complete the Request to Remove Advanced Practice Registered Nurse Authorization form at least six weeks before your expiration date.
Continuing Education
To maintain your RN license, you must complete 15 contact hours of continuing education every two years. Rules and regulations for this continuing education may be found here.
APRNs must demonstrate competence in order to maintain authorization in Massachusetts. This is achieved by completing continuing education and by maintaining national certification. You must complete the continuing education requirements of your national certification organization in order to maintain APRN authorization. Contact your agency for more details:
- American Academy of Nurse Practitioners
- American Nurses Credentialing Center
- American Association of Critical Care Nurses
- National Certification Corporation
- Pediatric Nurse Certification Board
- National Board of Certification & Recertification of Nurse Anesthetists
- American Midwifery Certification Board
Additionally, if you have prescriptive authority, you must complete and document continuing education in the following areas every two years:
- Effective pain management
- Identifying patients at high risk for substance abuse
- Counseling patients on drugs’ side effects and their proper storage and disposal
Expired Authorization Renewal
If you do not renew your license and/or authorization by 5:00 p.m. on its expiration date, your license/authorization automatically expires. Your license and/or authorization may not be placed on inactive status in Massachusetts. If your RN license and/or APRN authorization have expired, you may not legally practice in Massachusetts. Contact the Board for information on reinstating them.
Advanced Practice Registered Nurse Associations in Massachusetts
Consider joining one of the local associations that provide continuing education and professional support in Massachusetts:
- Massachusetts Coalition of Nurse Practitioners
- Eastern Massachusetts Chapter of National Association of Pediatric Nurse Associates and Practitioners
- Massachusetts Association of Nurse Anesthetists
- Massachusetts Nurses Association
- Massachusetts Midwives Alliance
Massachusetts Nurse Practitioner Salary
Those pursuing careers as NPs in Massachusetts can expect to make well over $100,000 a year. NPs earn an average of $126,050 a year in this state. What’s more, those in the top 10 percent report earning $167,850 annually.
Registered Nurse Salary
Registered nurses make a good living in Massachusetts: an average $96,250 per year. Even in this high-cost state, that income goes a long way. What’s more, those who have climbed the ladder report annual incomes of $146,480 or better.
Nursing Instructors and Teachers Salary
It’s no surprise nursing instructors make a good income in a state known for high education. In Massachusetts, these professionals report an average income of $106,950 per year.
Nurse Administrator Salary
(Includes Nurse Managers, Directors, and Chief Nursing Officers)
Have leadership qualities? Nurse administrators in Massachusetts report an average salary of $136,930 per year. Those who have been in the role for longer report making around $163,000 annually.
Nurse Anesthetists Salary
Nurse anesthetists in the Bay State make an astounding $195,900 per year, on average. However, it’s likely the top 25% of earners gross well over the Bureau of Labor Statistics’ reporting threshold of $208,000 per year.
Nurse Midwives Salary
Envision yourself in natal care? Nurse midwives in Massachusetts make an average $113,910 annually. Those who have been in the role longer edge toward $200,000 – the top 10 percent make a minimum $183,490 per year.
2020 US Bureau of Labor Statistics job market trends and salary figures for 1) Nurse Anesthetists, Nurse Practitioners, Nurse Midwives; 2) Medical and Health Services Managers (Nurse Administrators); 3) Registered Nurses; and 4) Postsecondary Nursing Instructors and Teachers reflect state data, not school-specific information. Conditions in your area may vary. 2019 US Census Bureau figures for state median household income provided for comparison. Data Accessed December 2021.