For nurse practitioners · Montana

Independent by rule since the early nineties.

Montana licenses APRNs under Board of Nursing rules that define APRN practice as an independent practice, with no physician collaboration or supervision requirement at any career stage.

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The moment

Independence attaches at licensure

Montana’s board granted APRNs prescriptive authority by rule effective December 13, 1991, and its current rules define APRN practice as an independent practice — no physician relationship appears at any career stage.

Prescriptive authority for legend and controlled drugs is an endorsement requested on the license application: an application, a fee, graduate pharmacology coursework. A paperwork gate, not a supervision gate.

The requirement

none — independence at licensure (prescriptive authority is a separate board endorsement with pharmacology coursework, but no supervised-hours gate and no physician involvement)

The moment it attaches

automatic — attaches at initial APRN licensure; optional prescriptive-authority endorsement is requested on the license application

The timeline

Long-standing; board APRN/prescriptive-authority rules effective Dec. 13, 1991; current 'independent practice' rule ARM 24.159.1406 effective Sept. 6, 2013

The statute

Mont. Code Ann. § 37-8-102; ARM 24.159.1406, 24.159.1461

Worth knowing

Montana's board granted APRNs prescriptive authority by rule effective December 13, 1991, and since 2013 its rules have flatly defined APRN practice as 'an independent and/or collaborative practice' — no physician tie appears anywhere in the chapter.

Mont. Code Ann. § 37-8-102; ARM 24.159.1406, 24.159.1461

Scope and carve-outs

The grant and the strings, at equal weight

Full scope within the licensed APRN role and population focus: medical diagnosis, treatment, ordering and interpreting tests. Prescribing legend and controlled drugs requires applying for a prescriptive-authority endorsement (ARM 24.159.1461-1463: application, fee, graduate pharmacology coursework) — a paperwork gate, not a supervision gate.

The watch

Pending in Montana

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 Montana that we can pin to a primary source. What has already taken effect is below.

Landed recently (1)

Recently effective

Montana voids noncompete terms restricting APRNs; the APRN Compact bill died in 2025 and cannot return until 2027.

Montana Code Annotated 2025, 28-2-724

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

No physician attached means no standing invoice between you and your own practice — the economics of independence here are unusually legible. What Gale adds is built to read the same way.

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 Montana’s; the same treatment is coming state by state. Until then, they show the depth of homework to expect from us.

The California playbook →
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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