For nurse practitioners · Florida

Autonomy is a registration — in primary care.

An APRN registers with the Board of Nursing for a distinct 'autonomous practice' designation under Fla. Stat. §464.0123, after which they may practice primary care without physician supervision or a protocol.

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The moment

The designation you apply for

Florida’s autonomy is a registration: an APRN with 3,000 physician-supervised clinical hours in the preceding five years — plus graduate-level coursework in differential diagnosis and pharmacology — registers with the Board of Nursing for the autonomous-practice designation, live since July 1, 2020.

The scope is the catch, and it gets equal billing: autonomous practice covers primary care — family medicine, general pediatrics, general internal medicine — plus autonomous midwifery for CNMs. The registration also carries a wallet test: $100,000 per-claim / $300,000 aggregate financial responsibility, the statute’s own figures.

The requirement

3,000 clinical practice hours under supervision of an allopathic or osteopathic physician within the 5 years preceding application, plus 3 graduate-level semester hours in differential diagnosis and 3 in pharmacology, and no discipline within 5 years

The moment it attaches

Board of Nursing approval of the autonomous-practice registration

The timeline

July 1, 2020 (HB 607, 2020)

The statute

Fla. Stat. §464.0123

Worth knowing

Florida pairs autonomy with a wallet test: since July 1, 2020, registered autonomous APRNs must carry $100,000-per-claim / $300,000-aggregate financial responsibility — a malpractice-coverage mandate most NP-autonomy states do not impose.

Fla. Stat. §464.0123

Scope and carve-outs

The grant and the strings, at equal weight

Autonomous practice ONLY in 'primary care practice, including family medicine, general pediatrics, and general internal medicine,' plus autonomous midwifery for CNMs (with written transfer-of-care policies); includes admitting, managing and discharging patients at facilities; may not perform any surgical procedure other than a subcutaneous procedure; must demonstrate financial responsibility ($100,000 per claim / $300,000 aggregate).

The watch

Pending in Florida

Statutes move, boards write rules, sunsets arrive. This watch is checked against primary sources on a standing cadence — last verified 11 August 2026 — and every item links the source it was read from.

Nothing pending in Florida that we can pin to a primary source. Quiet is a finding too — it means the ground your practice stands on is not moving this season.

Every jurisdiction, every item — The Watch →.

What Gale runs

The inventory, split honestly. Nothing dark is dressed as live.

In the product today

  • Chat runs the practice — say what you need in your own words, and Gale books it, finds the guide, or opens the screen already filled in.
  • Scheduling and the calendar.
  • Notes, with a scribe that drafts during the visit — you stay the final editor of every note.
  • Telehealth where the chart lives.
  • The patient record — see a sample chart, no signup.
  • Superbills for the patient who wants to claim out-of-network benefits.
  • The Fee Schedule — the one Gale document that states the fee.
  • Your practice page, in the public directory compiled from the NPPES registry.
  • Your credentials in one place — every license, DEA registration, board certification and plan enrollment you already hold, with reminders at 90, 60 and 30 days before one expires. Gale checks your NPI against the national registry and marks what it checked. It does not file applications; a credentialing service can.
  • Referrals from colleagues through your own link, acknowledged and booked in one place, and a view of which referral sources send you patients and which have gone quiet.
  • Practice notes on your public page, and your own notes on Gale’s health articles in the content library — credited to you, and nothing is public until you publish it.
  • An activity and access log that records who opened, changed or exported a patient’s chart, and when.
  • Connect Claude to set up your services, rates and hours by talking to it. It cannot open a patient record, move money or sign anything.

Opening with the founding cohort

  • Concierge memberships — a monthly plan your practice sells on its own terms. Not sellable yet: enrollment fails closed behind a legal switch until counsel clears it. No countdown — when it clears, it clears.
  • The loop tracker — every referral, lab, and question a visible loop with an owner, a state, and a promised window. Closing one requires an outcome note; nothing silently expires.
  • The guided founding sequence — practice setup walked step by step with the first cohort: entity, posted prices, the practice page, the first visit.
  • Currents — the regulatory watch for your state and the latest evidence for your specialty, dated, sourced, and re-verified on a standing cadence. Quiet weeks say so.

Built, on sample data for now

  • Insurance billing — a billing console, coding you review and attest, and every claim followed from draft to paid. Today a claim is checked by Gale’s own test system: nothing reaches a payer and no money moves.
  • Outreach — check-ins for patients who have drifted, drafted overnight for you to approve. Approving sends nothing yet; patient contact stays off until it opens.
  • Your panel, sorted so the patients who are due or slipping out of care come first — a sort order, not a prediction — with show rates and between-visit activity counted beside it.
  • Practice health — whether notes get signed and Good Faith Estimates go out on time.
  • Guidance monitoring — the between-visit guidance a patient chooses to share with you, with anything off track listed first. It fills as patients share.
  • Workbooks — your charts, claims, referral pipeline, compliance records and clinician roster as tables you can edit. New accounts start on a sample practice.
  • A desktop bridge and scheduled agents, for work that runs while you are away. A scheduled agent can never send a message, move money or sign anything.
The economics

The designation retires the supervising relationship and whatever it cost to keep. What Gale adds is built to stay just as legible.

Gale’s side of the ledger is deliberately short. The software is free, and Gale earns one flat all-in fee on a transaction — charged only when your practice is actually paid, never as a subscription, never with per-feature line items, never a spread on your rate. The number itself lives in exactly one document, on purpose, so it can never quietly say two different things in two places: the Fee Schedule states it.
The playbook

The deepest state cluster we have built is California’s — eight guides on the 103/104 ladder, cited to the statute and the board’s own filings. They are California’s rules, not Florida’s; the same treatment is coming state by state. Until then, they show the depth of homework to expect from us.

The California playbook →
Questions with citable answers
In practical effect, no. The statute limits autonomous practice to primary care — family medicine, general pediatrics, general internal medicine — and never names psychiatry. A psychiatric-mental-health practice falls outside that primary-care scope, so PMHNPs are effectively excluded even though no statutory text says so by name.
A registered autonomous APRN must demonstrate financial responsibility of $100,000 per claim and $300,000 aggregate — a malpractice-coverage mandate written into the registration statute itself, which most NP-autonomy states do not impose.
Admitting, managing, and discharging patients at facilities is included. Surgery is not: an autonomous APRN may not perform any surgical procedure other than a subcutaneous one.
Where to start

Your page may already exist

Gale publishes a public directory compiled from the NPPES registry. Find your listing, claim it, and see how you rank for your own name — that page is the front door your independent practice will be found through.

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