38th Annual APRN Legislative Update: Transformative change through APRN practice authority progress

The 38th Annual APRN Legislative Update provides a comprehensive state-by-state analysis of the legislative and regulatory landscape shaping the advanced practice nursing profession across the United States. Drawing on survey data collected from relevant authorities in all 50 states and Washington, D.C., the report highlights significant progress in 2025 toward full practice authority and prescriptive authority expansion for advanced practice registered nurses (APRNs). It also provides an overview of statutory and regulatory changes enacted or passed in 2025 that affect APRN practice nationwide. Key themes among these changes include steps toward administrative modernization, pathways to independent prescribing, and incremental gains in reimbursement parity. Persistent challenges remain, particularly in required transition to practice periods and equitable payment models. This year's edition of the Legislative Update underscores accelerating momentum toward dismantling APRN practice barriers and increasing APRN utilization to improve care access, quality, and cost-effectiveness.