Evidence status: CURRENT BINDING PROFESSIONAL REGULATION. Georgia Composite Medical Board Rule 360-3-.06 makes a written treatment agreement part of the minimum standards of practice in defined chronic-pain prescribing.

Quick read

When a physician prescribes a Schedule II or III controlled substance for 90 consecutive days or greater for treatment of chronic pain arising from a nonterminal condition, within the scope of Rule 360-3-.06, the physician must have a written treatment agreement with the patient.

Who and what the rule covers

The rule defines chronic pain as pain requiring treatment that has persisted for 90 days or greater in a year. It excludes perioperative pain immediately before and after surgery when treated by a physician in connection with the surgical procedure.

The written-agreement requirement is tied specifically to covered Schedule II or III controlled-substance prescribing for chronic pain. It is not a generic rule that every Schedule II or III prescription for every condition requires a pain agreement.

Clinical-visit requirement

For covered patients, the physician generally must require a clinical visit at least once every three months while treating for pain to evaluate response to treatment, compliance with the therapeutic regimen, and new conditions that may have been masked by the controlled substance.

The current rule allows that visit frequency to be reduced to at least once per year when the physician determines there is a substantial hardship and documents it, or when the morphine-equivalent daily dose is 30 mg or less.

Monitoring requirement

Georgia separately requires monitoring of compliance for covered chronic-pain prescribing. The rule defines monitoring as any method used to assure treatment compliance, including examples such as pill counts and pharmacy or prescription-program verification, and says monitoring must include a urine, saliva, sweat, or serum test performed on a random basis.

The current rule says covered patients should be randomly monitored at least annually by bodily-fluid analysis. The physician must respond to abnormal monitoring results and record that response in the patient’s record.

What the rule does not dictate

Rule 360-3-.06 does not set out a statewide model agreement or enumerate a mandatory list of contract clauses. It does not itself say that every agreement must require one pharmacy, ban cannabis, deny replacement of lost medication, impose a fixed pill-count deadline, require generic medication, or authorize automatic discharge after every violation.

Board FAQ: agreement violations and cannabis

The Georgia Composite Medical Board’s pain-rule FAQ addresses whether pain medication should be withheld from a patient under a narcotic agreement because the patient used an illicit substance, including cannabis. The Board’s answer states that the decision depends on the physician’s professional judgment and whether the patient represents a risk to self or others. The FAQ separately points to the rule’s requirement for an appropriate substance-abuse referral when a physician determines the patient is abusing prescribed controlled substances.

Separate PDMP duties

Georgia’s PDMP rule generally requires a prescriber to seek and review PDMP information the first time a controlled medication is prescribed and at least every 90 days thereafter, subject to listed exceptions. That is a separate regulatory requirement and should not be silently treated as a clause that must appear in the written treatment agreement.

Primary sources

← Georgia Contract-for-Care Evidence Library

Reviewed: October 4, 2026.

Evidence boundary: Applicability depends on the patient’s treatment, drug schedule, duration, and the scope of Rule 360-3-.06. This is a public-source legal record, not a patient-specific legal conclusion.