How To Set Up Private Practice As A PMHNP – (11 Simple Steps)


Written By: Kasee WiesenKasee Wiesen DNP, APRN, FNP-C

Kasee Wiesen is a practicing family nurse practitioner. Her nursing background includes emergency medicine, pediatrics and peri-op. She started her health career as a nurse’s aid while pursuing her bachelor’s in nursing degree in a hospital setting. Education is a passion of Kasee’s, and after working as a BSN prepared nursed, she obtained in master’s in nursing education and began teaching adjunct for a local university. Read Full Bio »»
DNP, APRN, FNP-C


There is a significant need for great psychiatric mental health nurse practitioners (PMHNPs)—especially as the need for mental health services is growing. A recent study determined that 1 out of 5 adults live with a mental illness—and the aging and growing population, along with the current pandemic, play a role in the need for more PMHNPs.

And while the need is there, there is a shortage of mental health providers to meet the needs of people worldwide. I can tell you from my own practice that there have been challenges getting appointments with behavioral health specialists due to many practices not accepting new patients. This further supports the demand for more nurse practitioners to open a psychiatric mental health practice. So, how do you set up a private practice as a PMHNP? Below, I will discuss 11 simple steps to set up a private practice as a PMHNP.



Can a PMHNP Set Up a Private Practice?


Each state has its own scope of practice for a nurse practitioner, determining if a psychiatric mental health NP can open their practice. Currently, 27 states allow PMHNPs to open private practices, but some guidelines must be followed for each state. For example, one state may require that the NP has two years of experience under the direct supervision of a physician before opening their practice. In contrast, another state may not have any requirements, and the NP can open their practice right after graduation.

For specific information, visit your state’s Board of Nursing, as this is where you will find the information you need regarding opening your own PMHP private practice.


What States Allow Psychiatric Mental Health Nurse Practitioners to Set Up a Private Practice?


Twenty-seven states allow psychiatric mental health nurse practitioners to set up a private practice. These states grant nurse practitioners full practice authority, enabling them to practice independently of a physician or supervising provider.

AlaskaArizonaNevadaOregonWashington
IdahoMontanaWyomingColoradoKansas
NebraskaSouth DakotaNorth DakotaMinnesotaIowa
New YorkMaineVermontDelawareNew Hampshire
MassachusettsConnecticutRhode IslandMarylandHawaii
New MexicoUtah



Top 3 Pros of Setting Up a Private Practice as a PMHNP


There are many pros of setting up a private practice as a PMHNP, and below, I list 3 of these reasons.

PRO #1: Complete autonomy of your practice.


PRO #2: Greater flexibility in your career, leading to better work-life balance.


PRO #3: Leave a lasting impact on your patient’s overall health with improved patient outcomes.



How Much Does It Cost Psychiatric Mental Health Nurse Practitioners to Set Up a Private Practice?


The cost to set up a private practice as a PMHNP can vary widely based on numerous factors, including the type of practice that will be opened (telemedicine-only practice will most likely be cheaper as you often don’t need a space to rent), state or town opened and the size of the overall practice.

However, I found an estimated cost of between $24,500 and $120,000 to open a private practice as a nurse practitioner. These estimated costs include rent, legal expenses, bookkeeping tools, staff pay and benefits, electronic medical records, and marketing costs.



How Long Does It Take Psychiatric Mental Health Nurse Practitioners to Set Up a Private Practice?


The time it takes to set up a private practice as a PMHNP will vary based on factors such as the space you are looking for, how many employees you hire, and the time you have to commit to starting your business. On average, though, expect it to take 3-6 months to open their practice. This may take less if you open a telehealth practice from home.



How to Set Up a Private Practice as a PMHNP?

Below you will find 11 steps to help you successfully set up a private practice as a PMHNP.


STEP #1: Graduate from an accredited psychiatric mental health NP program.

The first step to setting up a private practice as a PMHNP is to graduate from an accredited PMHNP program. This can be either an MSN or DNP program—and if you haven’t started your journey yet, I would strongly recommend completing a DNP program as it will better prepare you for the business and leadership aspect of owning your practice.


STEP #2: Become a board-certified psychiatric mental health NP

You must complete the board certification exam after graduating from an accredited PMHNP program—the two most popular are the Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC™) through the ANCC or the PMHNP certification examination through the AANP. If you do not pass the exam, you can take it up to 3 times a year with a minimum of 2 months between exams—and you must complete at least 15 hours of continuing education in your weak areas.


STEP #3: Obtain NP and RN licensure in the state where you wish to open your psychiatric mental health practice.

After completing the PMHNP board certification exam, you must obtain licensure in the state where you want to open your private practice. To do this, you must also have an active RN license in the state where you are opening your practice.


STEP #4: Consider the legal requirements needed to open your own NP practice.

Each state will have its own rules and regulations regarding NPs opening their psychiatric mental health practice. Therefore, ensure you have all requirements, such as certifications, documents demonstrating the required number of supervised hours completed, or any other forms needed. Also, be sure to look into malpractice insurance for yourself, employees, and the business.


STEP #5: Create a business plan.

The next step in setting up a private practice as a PMHNP is creating a business plan. This is essential as it lays the foundation for your private practice. One piece of this is your financial plan, which looks at your estimated expenses, revenues, and profits. This will help determine which insurance you will accept and the process you will use for billing. Your business plan will also help project ways to grow over one year, two years, or five years.

By having a solid business plan in place, you are more likely to secure loans needed when starting a practice and develop relationships with investors if required.


STEP #6: Find a space to rent.

This step is interchangeable with the next couple of steps, but you must start to look for a place to rent. It will be most beneficial to have your business plan created first, as this will help guide you into how large of a space you are looking for. Your business plan will also help you set the budget for the rental space. Depending on location, rent may be expensive, so it is essential to start this journey early to ensure you can find a space that fits within the business budget.


STEP #7: How will you market your business?

How are you going to market your private practice, and when are you going to start? Marketing is crucial to setting up your private practice as a PMHNP because this is how you will get the word out about your practice and get patients. Are you going to market through social media? Have you scheduled meetings with providers in surrounding clinics, including family practice and pediatrics, and local counselors? Will you utilize handouts, flyers, or other paper advertisements?

These are just a few marketing techniques you should consider to get the word out about your practice. Personally, I refer patients to specific behavioral health specialists that I have met personally (maybe through a provider lunch or meeting) or through word of mouth. Timing is also a vital component of this, so be sure you do not advertise early enough that clients may forget about you, but do not wait until the last minute as this may lead to a delay in obtaining clients and earning a living.


STEP #8: Decide on an electronic medical record system that will be used.

What electronic medical record (EMR) system are you going to use? Various options are available, making it vital to know your needs and expectations of the EMR you are implementing. Some points to consider include cost, function, customer service support, implementation, and ease of use.


STEP #9: Will you utilize telehealth services and if so, which system will you use?

Telemedicine has been part of healthcare for a while, but since the start of the COVID-19 pandemic, it has become a more common practice, especially in delivering mental health services. It can be convenient for patients and providers and may even increase access to psychiatric services for many patients. While I am not a psychiatric mental health NP, I still use telehealth routinely to complete medication checks with many of my patients and can tell you they have appreciated the option of telehealth appointments, specifically for its convenience.

And while there are many great uses for telehealth, there are a couple of points to consider. Are you going to implement telehealth as a scheduling option for your patients? And what type of appointment will be scheduled as telehealth? Or will there be guidelines such as initial visits must be in person? What system will you implement to ensure HIPPA compliance during telehealth appointments?


STEP #10: Determine staffing needs.

You have probably thought about this, but what are your private practice staffing needs? Are you the sole provider, or will there be other providers that you will employ? This is the first step, as it will help guide how many nurses and clinical staff you will need. You must also consider hiring an office manager and have their job description clearly defined. How many receptionists will you need? Do you need a person in billing and coding?

A strong understanding of your staffing needs and ensuring adequate support throughout the clinic is essential to running a successful practice.


STEP #11: Open your psychiatric mental health private practice and thrive.

Lastly, open your psychiatric mental health private practice and help meet the psychiatric needs of your community and surrounding communities.

And remember to be proud of the hard work you put into achieving this goal!



My Final Thoughts


After reading the article above, I hope you can answer how to set up a private practice as a PMHNP. Psychiatric mental health NPs are in demand, as evidenced by the growing need for psychiatric mental health services and the shortage of providers. I hope you found the 11 simple steps to set up a private practice as a PMHNP listed above helpful and provide guidance as you achieve your dream of opening your practice.



Frequently Asked Questions Answered by Our Expert


1. Can A PMHNP Set Up A Private Practice In California?

No, the scope of practice for PMHNPs in California does not allow them to open their practice.


2. Can A PMHNP Set Up A Private Practice In Florida?

No, PMHNPs can not set up a private practice in Florida.


3. Can A PMHNP Set Up A Private Practice In Texas?

Due to the restricted scope of practice for nurse practitioners in Texas, PMHNPs cannot open their practice.


4. Can A PMHNP Set Up A Private Practice In New York?

Yes, PMHNPs can set up their private practice in New York.


5. Can A PMHNP Set Up A Private Practice In Pennsylvania?

No, the scope of practice for nurse practitioners in Pennsylvania is reduced. Therefore, PMHNPs cannot open their own practice.


6. Can A PMHNP Set Up A Private Practice In Georgia?

No, PMHNPs can not set up a private practice in Georgia.


7. Can A PMHNP Set Up A Private Practice In Massachusetts?

Yes, nurse practitioners have full scope of practice in Massachusetts, allowing PMHNPs to open their private practice.


8. Can A PMHNP Set Up A Private Practice In Illinois?

PMHNPs cannot open their private practice in Illinois due to their reduced scope of practice.


9. Can A PMHNP Set Up A Private Practice In Ohio?

No, nurse practitioners in Ohio have a reduced scope of practice for nurse practitioners in Ohio which prevents PMHNPs from opening a private practice.


10. Can A PMHNP Set Up A Private Practice In North Carolina?

No, PMHNPs cannot set up a private practice in North Carolina due to the restricted scope of practice for nurse practitioners.


Kasee Wiesen DNP, APRN, FNP-C
Kasee Wiesen is a practicing family nurse practitioner. Her nursing background includes emergency medicine, pediatrics and peri-op. Education is a passion of Kasee’s, and she has taught BSN, RN-BSN and DNP students, and has enjoyed every moment of it!