How to Become a Prescribing Psychologist
Prescribing psychologists do something most psychologists can't: they prescribe medication. It's a small but growing path that sits between psychology and psychiatry. Here's exactly how it works, which states allow it, and what it takes to get there.
Key Takeaways
- A prescribing psychologist is a licensed doctoral psychologist who has earned prescriptive authority (RxP) and can prescribe psychotropic medication in addition to providing therapy.
- RxP is currently legal in only six states: New Mexico, Louisiana, Illinois, Iowa, Idaho, and Colorado, plus some federal settings. In every other state, psychologists cannot prescribe.
- The path is long. You first become a licensed clinical psychologist, then complete a postdoctoral APA-designated MS in Clinical Psychopharmacology, supervised practice, and the national PEP exam.
- Prescribing psychologists generally out-earn non-prescribing peers because medication management is billable. Base clinical psychologist pay runs a median of $100,580 before that premium.
- The role exists largely to widen access to psychiatric care. In rural and underserved areas with few psychiatrists, prescribing psychologists help fill a real gap.
What Does a Prescribing Psychologist Do?
A prescribing psychologist is a licensed doctoral psychologist who has gone through extra training to earn prescriptive authority, known as RxP. That means they can do everything a clinical psychologist does, assessment, diagnosis, and therapy, and also prescribe and manage psychotropic medications. It is the only path that lets a psychologist treat the whole picture, talk therapy and medication, under one provider.
The role grew out of a real access problem. There are not enough psychiatrists, especially in rural and underserved areas, and patients often wait months to see a prescriber. Prescribing psychologists help close that gap. The movement started in the military, where the Department of Defense trained psychologists to prescribe, and it has slowly expanded into civilian practice in a handful of states.
Here is the part to be clear about: this is a small field with a narrow geographic footprint. Prescriptive authority is legal in only six states plus some federal settings. If you practice in one of those states, RxP can transform your practice. If you do not, the training still sharpens your medication knowledge and consultation skills, but you will not be able to prescribe.
Key Duties & Responsibilities
- Prescribe and manage psychotropic medications for mental health conditions, within the limits of state RxP law
- Provide psychotherapy and combine it with medication management under a single provider
- Conduct assessment, diagnosis, and treatment planning as a licensed clinical psychologist
- Order and interpret relevant labs and monitor for side effects and drug interactions
- Collaborate with primary care physicians, psychiatrists, and other prescribers on integrated care
- Adjust or taper medications based on response, and coordinate with therapy goals
- Serve rural and underserved communities where psychiatric prescribers are scarce
- Stay current on pharmacology, which RxP licensure requires through continuing education
Common Specializations
How to Become a Prescribing Psychologist
Becoming a prescribing psychologist is a two-stage journey. First you become a fully licensed clinical psychologist, which is already a decade of work. Then you add the postdoctoral psychopharmacology training and pass a national exam to earn prescriptive authority. There is no shortcut, and the second stage assumes you have finished the first.
Because RxP laws vary by state, the exact requirements depend on where you plan to practice. The general path looks like this:
Become a Licensed Clinical Psychologist
10–12 years
This is the foundation. Earn a bachelor's degree, then a doctorate (PhD or PsyD) in clinical or counseling psychology from an APA-accredited program, complete a predoctoral internship and postdoctoral supervised hours, and pass the EPPP for state licensure. Plan for 10 to 12 years. See our clinical psychologist guide for this stage in detail.
Complete an APA-Designated MS in Clinical Psychopharmacology
2–3 years
Enroll in a postdoctoral MS in Clinical Psychopharmacology (MSCP) that holds APA designation. There are only seven of these programs in the country, most delivered online. The degree covers the biomedical science, pharmacology, and physical assessment skills you need to prescribe safely. It usually takes two to three years part-time.
Complete Supervised Clinical Training
1–2 years
Most states require a supervised practicum or fellowship in which you treat patients and manage medication under the supervision of a physician or experienced prescribing psychologist. This is where the classroom training becomes real prescribing practice. Some programs, like CU Denver's Prescribing Fellowship Certificate, build this step in.
Pass the PEP Exam
Varies
Sit for the Psychopharmacology Examination for Psychologists (PEP), the national exam administered by ASPPB that states use to verify prescribing competence. Passing it is a standard requirement for RxP licensure in the states that grant prescriptive authority.
Apply for Prescriptive Authority in Your State
6 months – 1 year
Submit your credentials to your state psychology board for a prescribing license or certificate. Requirements differ by state, and some include a conditional or provisional prescribing period under physician collaboration before full authority. Confirm your state's exact rules, since RxP is legal in only six states plus federal jurisdictions.
Prescribing Psychologist Education Requirements
There is no single "prescribing psychologist" degree. You build the credential in two pieces: a doctorate in psychology that gets you licensed, and a postdoctoral MS in Clinical Psychopharmacology that adds the prescribing training on top.
The doctorate has to come from an APA-accredited clinical or counseling program, the same requirement as for any licensed psychologist. The postdoctoral piece has to be an APA-designated psychopharmacology program, because most RxP states will not grant prescriptive authority on the basis of a non-designated degree. We rank the seven designated programs on our best online psychopharmacology programs page.
One thing worth saying plainly: do not pursue the MSCP first. It is postdoctoral by design and assumes you already hold a doctorate and a license. If you are early in your education, the right starting point is a doctoral program in clinical psychology.
- A doctorate (PhD or PsyD) in clinical or counseling psychology from an APA-accredited program
- An active psychology license, earned by passing the EPPP and meeting state requirements
- A postdoctoral MS in Clinical Psychopharmacology from an APA-designated program
- Supervised clinical prescribing training, the length of which varies by state
- A passing score on the national PEP exam plus your state's RxP licensure requirements
Recommended Degree Programs
Best Online Clinical Psychopharmacology Programs
The seven APA-designated postdoctoral MSCP programs that lead to prescriptive authority, ranked.
Doctorate in Clinical Psychology (PsyD)
The doctoral degree and license that has to come first, before any psychopharmacology training.
Best Online Clinical Psychology Programs
Clinical doctoral programs that build the licensure foundation for an RxP career.
How Much Do Prescribing Psychologists Make?
There is no separate BLS category for prescribing psychologists, so the cleanest baseline is the clinical and counseling psychologist median, which the BLS reports at $100,580 as of May 2025. Prescribing psychologists generally earn above that baseline.
The reason is simple: medication management is a billable service, and a prescribing psychologist can offer both therapy and prescribing under one roof. That adds revenue streams a therapy-only psychologist does not have, and in underserved areas where prescribers are scarce, the demand is strong. Exact figures vary widely by state, setting, and whether you run a private practice, but the prescribing credential consistently raises earning potential above the standard psychologist median.
10th Percentile
$55,170
Median
$100,580
90th Percentile
$180,960
Top-Paying Factors
- Prescriptive authority itself, since medication management adds billable services to a practice
- Private practice ownership, where you capture the full value of integrated therapy plus prescribing
- Practicing in an RxP state with a shortage of psychiatric prescribers, where demand and rates are highest
- Integrated primary care and rural health settings that specifically need prescribing psychologists
- Federal and military roles, where the prescribing psychologist model originated and remains active
What's the Job Outlook for Prescribing Psychologists?
Growth Rate
6%
Total Jobs
204,300
Overall psychologist employment is projected to grow 6% through 2034, but the prescribing niche has its own momentum tied to state legislation.
The RxP movement is slowly winning ground. New Mexico and Louisiana led in the early 2000s, Illinois, Iowa, and Idaho followed in the 2010s, and Colorado became the sixth state in 2023. Bills appear regularly in other state legislatures, and each new RxP state expands the map of where prescribing psychologists can practice. The underlying driver is the national shortage of psychiatric prescribers, which is not going away.
Be realistic about the constraints, though. The field is still small, the path is long, and organized psychiatry actively opposes RxP expansion in many states. This is a career to pursue if you are committed to integrated care and either already practice in an RxP state or are willing to relocate to one.
Where Do Prescribing Psychologists Work?
Private Practice
Many prescribing psychologists run their own practices, where they can bill for both therapy and medication management. This is where the prescribing credential delivers the most financial upside, though it comes with the usual demands of running a business.
Highly variable; integrated therapy plus prescribing raises revenue potential
Integrated Primary Care & Community Health
Primary care clinics and community health centers increasingly embed prescribing psychologists to handle mental health medication on site, reducing referrals and wait times for patients.
$100,000–$140,000 depending on setting and state
Rural & Underserved Health Systems
Rural health systems in RxP states value prescribing psychologists precisely because psychiatrists are scarce. These roles often come with loan repayment and strong demand.
$110,000–$150,000 with incentives in shortage areas
Military & Federal (DoD, VA, IHS)
The prescribing psychologist model began in the Department of Defense, and federal settings still train and employ them. These roles come with structured pay and benefits.
$100,000–$140,000 plus federal benefits
Hospitals & Health Systems
Some hospitals and academic medical centers in RxP states employ prescribing psychologists as part of behavioral health teams that integrate therapy and pharmacology.
$105,000–$145,000 depending on system and region
Pros & Cons of Being a Prescribing Psychologist
Pros
- You can treat the whole picture, therapy and medication, under one provider, which many patients prefer
- Strong earning potential, since medication management adds billable services beyond therapy alone
- Real impact in underserved areas, where you may be one of very few psychiatric prescribers available
- A growing field, with new states periodically adding prescriptive authority
Cons
- The geography is narrow. Only six states plus federal settings currently allow psychologists to prescribe
- It is one of the longest paths in the field, a doctorate and license followed by a postdoctoral MSCP, supervised hours, and a national exam
- Organized psychiatry actively opposes RxP, so the political fight to expand it is ongoing and sometimes contentious
- The added training costs real time and money on top of an already expensive doctorate
A Day in the Life of a Prescribing Psychologist
Here is a realistic day for a prescribing psychologist running an integrated practice in an RxP state. The schedule mixes therapy, medication management, and the coordination that comes with prescribing.
Typical Schedule
8:00 AM — Review labs and overnight messages, check for any medication side effects reported by patients
9:00 AM — Therapy session with a long-term patient, with a brief medication check at the end
10:30 AM — New patient evaluation: full assessment, diagnosis, and a discussion of whether medication fits the treatment plan
12:00 PM — Lunch and documentation, plus a call with a primary care physician to coordinate a shared patient's care
1:30 PM — Medication management appointments: dose adjustments, monitoring, and tapering decisions
3:00 PM — Combined therapy and medication session with a patient managing depression and anxiety
4:30 PM — Review continuing-education material on a new psychotropic, required to keep prescriptive authority current
5:30 PM — Wrap up charting, refill requests, and prior authorizations before the day ends
Expert Insight
"The prescribing psychologists I trained went into this for one reason: they were tired of diagnosing a patient, knowing exactly what would help, and then having to send them away to wait three months for a psychiatrist. RxP closes that gap. The training is rigorous and the path is long, but if you practice in a state that allows it, being able to treat both the mind and the medication under one roof changes what you can do for people. My advice is to be sure about your state, because the law is everything in this field."
Dr. Daniel Reyes, PhD, MSCP, prescribing psychologist
Director of Integrated Behavioral Health, Community Health Network
Related Careers
Clinical Psychologist
The license and doctorate that come first. Prescribing psychologists are clinical psychologists with added authority.
Neuropsychologist
Studies brain-behavior links, with overlap in the biomedical knowledge that prescribing requires.
Child Psychologist
Works with children and adolescents, a population where medication decisions are especially sensitive.
Counselor
A shorter, master's-level mental health path, though counselors cannot prescribe.
Ready to Get Started?
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Sources
- U.S. Bureau of Labor Statistics — Psychologists, Occupational Outlook Handbook (2024)
- APA — Designation of Postdoctoral Programs in Psychopharmacology
- APA Division 55 — American Society for the Advancement of Pharmacotherapy
- APA — Prescriptive Authority for Psychologists
- ASPPB — Psychopharmacology Examination for Psychologists (PEP)