Coalition for Nurses in Advanced Practice
Five Steps to Obtaining DPS and DEA Numbers
Just like a physician, an APN who writes a prescription for a controlled substance in Texas must have a state controlled substances permit issued by the Texas Department of Public Safety (DPS) and a federal Drug Enforcement Agency (DEA) number. There are five steps each APN must complete before signing a prescription for a controlled substance.
STEP 1 – APNs must have full authorization to practice as an APN from the BON. Those with Interim Approval are not eligible to prescribe controlled substances.
STEP 2 -- The delegating physician must agree to delegate authority to prescribe controlled substances and affirm the agreement in the prescriptive authority protocol.
The protocol should reflect that the APN may prescribe controlled substances, what schedules of controlled substances may be prescribed, and any restrictions on that authority. By law, the APN has certain restrictions on prescribing controlled substances, and for clarity, these restrictions should be included in protocols. APNs are limited to prescribing:
- Schedules III-V;
- a maximum 30-day supply with no refill (increases to a 90-day supply on September 1, 2009);
- additional prescriptions for the individual, only with prior consultation with the physician; and
- for persons younger than 2 years of age only after prior consultation with the physician.
In addition, any consultation with the physician must be noted in the patient’s chart. The physician can place additional limitations on the APN’s authority to prescribe controlled substances, just as he/she can in delegating authority to prescribe any other drugs. If the physician elects to impose any additional restrictions, include those limitations in the protocol.
STEP 3 – The APN must register as a person who may prescribe controlled substances with the Texas Department of Public Safety DPS. This cannot be accomplished online, but the APN can request the application form by email. There is a $25 fee and the permit must be renewed annually.
To request the DPS registration form go to the Texas Department of Public Safety Website, Controlled Substances Registration Program. The application form is accompanied by a cover letter that explains what information and signatures must be included on the completed form. For efficient processing, the following instructions must be followed precisely.
- Provide the name and business address of the practice site. (Addresses must be a physical location, not simply a PO Box.) Even if you have prescriptive privileges in more than one site, most APNs will only have to apply for a permit for one site. Only if the APN is the person responsible for storing and maintaining records on controlled substances at multiple sites will the APN have to register for more than one permit. If the physician/medical director is responsible for the controlled substances, then the APN only registers for the primary site. If the site changes in the future, the APN will be required to notify DPS in writing and the new delegating physician will need to sign that form (see below).
- APNs must specify the APN title they have been authorized to use by the Board of Nurse Examiners (e.g. FNP, GNP, PNP, etc). Avoid academic and certification credentials such as MSN, APRN, BC or C, etc. Using these credentials on the application to identify the APN’s role and specialty could cause the application to be returned.
- Write your name on the application IDENTICALLY to your name as it appears on your RN license. If there are name changes, the name must be changed with the BNE prior to submitting the application to DPS.
- The name, contact information, and signature of the delegating physician are required. If additional physicians currently delegate prescriptive authority, they must also sign the application form.
Once submitted, the DPS issues the permit within 60 days. However, many APNs receive the permit much more quickly.
STEP 4 - Obtain a DEA number. The application form for the federal Drug Enforcement Administration (DEA) license number can be submitted by two methods. One may download and complete the PDF version of the DEA 224 application form and mail the application. This is the only method by which one can pay by check. The second method is highly recommended if the applicant’s browser supports 128-bit encryption and can pay the application fee using VISA, MasterCard, Discover or American Express. This On-Line Application System allows one to complete and submit the form online and will reduce potential errors and processing time. For the online submission form, go the DEA Diversion Website. The application fee is $551. That fee covers a period of approximately 3 years. (The initial DEA registration period may vary from a minimum of 28 months to a maximum of 39 months.)
The DEA registration process is very easy, but it is important to get all the details right. Any inconsistent answer can cause delay in processing your application. In completing the application form, there are a few questions that may require explanation.
In Section 2 where applicants are asked information on business activities and schedules of drugs. In the space that asks for business activity, select “Mid-Level Practitioner” and for the professional degree, put “NP.” Put “NP” no matter what type of APN you are, or even if you are a CNS, CRNA or CNM. In this instance, NP represents a broad category and it is the most appropriate option available. DEA staff in Washington D.C. is aware of this limitation and may expand the number of options available under “professional degree.” However, until then, no matter what type of APN you may be, you are required to select from the list provided on the application and will not be misrepresenting yourself if you mark “NP” on this application.
In Section 3, applicants are asked to mark the drug schedules. APNs in Texas check four boxes, “Schedule III Narcotic,” “Schedule III Non Narcotic,” “Schedule IV” and “Schedule V.” Do not check the box labeled “order forms.” These order forms are triplicate prescription pads and are only required in Texas when prescribing Schedule II drugs.
In Section 4, enter your Texas RN license number. Under “State Controlled Substance License,” mark “yes” if you already received your DPS permit and then record the DPS permit number in the box labeled “State Controlled Substance No.” If you have applied for your DPS permit, but not yet received it, mark “Pending.” Remember that the DEA application you submit will not be processed until the DPS permit has been issued.
STEP 5 – Writing the prescription for a controlled substance. Prescriptions for Controlled Substances, Schedules III – V are written on a standard prescription form or may be faxed or called to the pharmacy. APNs do not need to change their prescription pads just because they obtain a DEA number. While some may wish to print their DPS and DEA numbers, in addition to their BON prescriptive authority number, on the prescription form, it is not required to do so. However, the APN must know that the Texas State Board of Pharmacy and DPS require that the DPS and DEA number for the APN and the DEA number for the delegating physician be included on a prescription for any controlled substance. The APN may print these numbers on the prescription form by hand.
The Texas State Pharmacy Board requires the following information to be included on the prescription form.
- APN’s name and professional credentials (i.e. RN, FNP)
- APN's BON prescriptive authority number
- APN's practice site address and phone number
- Delegating physician's name and professional credentials
- Delegating physician's business address and phone number (if different than APN's)
- APN's and delegating physician's DEA numbers and APN's DPS number if prescription is for a CS.
To read the pertinent BON rules that include other requirements for prescriptions, read BON Rule 222.4 (c).
Please remember that promoting good working relationships with pharmacists in your area is always time well spent. If you will be prescribing controlled substances, it is a good idea to write a letter to all the local pharmacies explaining that physicians have the option of delegating prescriptive authority for Controlled Substances, Schedules III – V, and that your collaborating physician has delegated that authority. You can refer the pharmacists to the explanation of HB 1095 in the TSBP Newsletter, Fall 2003 issue, page 2. The pharmacist may also call the TSBP for information on filling prescriptions signed by an advanced practice nurse.
If you need to review the medications that are included in the various schedules of controlled substances, go to the DEA Diversion Website or to the Texas Department of State Health Services.
Renewal of DPS and DEA Numbers
and Maintaining Current Information
It is absolutely essential that APNs who have DPS and DEA numbers, keep their contact information current with those agencies. Those agencies mail renewal reminders; but failure to receive that notice is not an excuse for letting your DPS permit or DEA registration lapse. If an APN writes prescriptions for controlled substances after either the DPS permit or DEA registration lapses, then the APN is committing a criminal act. Prescribing these medications without proper permits from TX DPS and DEA can result in a criminal conviction. The convictions range from third degree felony to a state jail felony (up to 25 years). They can also be accompanied by a fine of up to $100, 000. In addition, the APN would also be in violation of the Nurse Practice Act because the APN is not conforming to all state and federal laws.
Unlike the DEA registration that only needs to be renewed once every 3 years, the DPS permit must be renewed annually. Just because the APN has a valid DEA number does not permit the APN to prescribe controlled substances unless the APN also has a valid DPS number.
DPS Change of Information Form. If the APN changes practice sites, and /or delegating physicians, the APN must complete and submit Form MODPAAPN to the DPS.This is the form in which an APN reports a change in business address and/or delegating physician/s.
DPS Permit Renewal. A renewal application is mailed to the registered location 60 days prior to the expiration date. Obviously, if the APN changed practices and did not update that information with the DPS, the form will be mailed to the wrong address. Just as with your nursing license, not receiving the renewal notice is not a valid excuse for failing to renew.
DEA Change of Information. DEA also requires you inform them of a change in your status. This includes changes in name, address, or the schedules you may prescribe. These registration change request forms can be downloaded from the DEA Web Site.
DEA Registration Renewal. Renewal applications are mailed automatically to the registered location 60 days prior to the expiration date. However, APNs may renew their DEA registration online.
Re-Activating a Lapsed DEA Registration. Because the ability to order controlled substances varies from state to state, it is not uncommon for APNs to have had a DEA number in one state, but let it lapse because the APN moved to a state that did not have prescriptive authority for controlled substances.
APNs that are not certain of the status of their DEA registration may call 800-882-9539 to find if the number is only expired, or if the number has been retired. If the number is expired, ask the registration technician to send you a renewal application or complete a renewal application online. If your DEA number has been retired, then complete a new DEA application form just like other new applicants. In either case, DEA will send a new DEA certificate.
Jolene Zych (personal communication, May 13, 2005).
© 2006 Coalition for Nurses in Advance Practice
P.O. Box 5047; Austin • Texas 78763-5047 • 512-469-7882