A nurse practitioner or clinical nurse specialist must practice at least 2,080 hours within a collaborative agreement with physicians or APRNs, then submits written evidence of completion to the Board of Nursing to practice independently. Since August 1, 2026 the general requirement to earn those hours in a hospital or integrated clinical setting is gone; under new subd. 1d, only NPs and CNSs providing services other than primary care or mental health must complete the agreement in a setting where APRNs and physicians work together.
Minnesota’s 2014 modernization law reserved its transition for NPs and clinical nurse specialists: 2,080 hours of practice within a collaborative agreement — with a physician or an APRN experienced with the same or similar medical problems. Those hours once had to be earned in a hospital or integrated clinical setting; the 2026 session struck that requirement effective August 1, 2026, so NPs in primary care and mental health may earn them in an independent practice, while NPs outside those two fields must earn them in a setting where APRNs and physicians work together. An APRN collaborator now needs at least three years of APRN practice. Written evidence of completion goes to the Board of Nursing, and independent practice, prescribing included, follows. The statute states the requirement as hours, not a duration.
The transition
2,080 hours of practice within a collaborative agreement — in a setting where APRNs and physicians work together only for NPs outside primary care and mental health
The moment it ends
Submission of written evidence to the Board of Nursing that the 2,080 collaborative-practice hours are complete (filed with the APRN application, or upon completing the hours)
The timeline
2014 APRN modernization law (2014 Minn. Laws ch. 235), effective Jan. 1, 2015; amended by 2026 Session Laws ch. 115 (HF 3825, signed May 27, 2026), art. 11, which struck the setting restriction for primary-care and mental-health NPs effective Aug. 1, 2026
Minnesota's 2014 law (effective Jan. 1, 2015) reserved its 2,080-hour transition for NPs and clinical nurse specialists only — CRNAs and nurse-midwives walked straight into full practice — and in 2026 it let primary-care and mental-health NPs earn those hours outside settings where APRNs and physicians work side by side.
Full scope after the hours, including independent prescribing. During the transition, practice must occur within a collaborative agreement with physicians experienced with the same or similar medical problems, or with APRNs who have at least three years of APRN practice and that experience. Since August 1, 2026 the hospital-or-integrated-clinical-setting requirement is struck; for NPs in primary care and mental health the hours may be earned in an independent practice, while NPs outside those fields must complete the agreement in a setting where APRNs and physicians work together. The TTP applies only to NPs and clinical nurse specialists — nurse anesthetists and nurse-midwives are not subject to it.
The watch
Pending in Minnesota
Statutes move, boards write rules, sunsets arrive. This watch is checked against primary sources on a standing cadence — last verified 9 November 2026 — and every item links the source it was read from.
Nothing pending in Minnesota that we can pin to a primary source. What has already taken effect is below.
Landed recently (1)
Recently effective
Minnesota primary-care and mental-health NPs may now complete transition hours outside a hospital or integrated clinical setting.
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.
Tasks for you and your team, each with a due date, a priority and, if you choose, the patient it is about.
Supervision for the notes you co-sign: send a progress note back with a comment, or sign it yourself. Gale never signs for anyone.
A notifications inbox with the messages Gale sends you, each in full, and the unread ones marked.
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 it is turned on. No countdown — when it opens, it opens.
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, rolling out
Insurance billing — a billing console, coding you review and attest, and every claim followed from draft to paid. Claims are filed to payers through Stedi, Gale’s signed clearinghouse, once insurance is on for your practice.
Outreach — check-ins for patients who have drifted, drafted overnight for you to approve. Nothing is sent until you approve it.
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.
Analytics for the date range you pick — income, balances, claims, appointments and notes, and each report as a download. The money figures come from the same test system as billing.
Visit requests — the kind of visit a patient asks for, with a suggested length, checked off once the time is booked. For now a request is kept only in the browser it was sent from.
The economics
During the transition, someone signs — and the signature is a cost line, in money or in kind. Independence retires it. 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 a fee on a card payment it takes or a flat fee on a claim your practice collects on its own — never as a subscription, never with per-feature line items, never a spread on your rate. The numbers themselves live 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 Minnesota’s; the same treatment is coming state by state. Until then, they show the depth of homework to expect from us.
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.