Scope of Practice - Physician Assistants

Physician Assistant Scope of Practice: State by State

Key Elements of State Regulation of Physician Assistants:
• "Licensure" used as the Regulatory Term
• Full Prescriptive Authority
• Is Scope of Practice determined at the Practice Level?
• Are there Adaptable Collaboration Requirements?
• Are Co Signature Requirements Determined at the Practice Level?
• Is there a limit on the number of PAs a Physician Can Oversee?

The boundaries of each PA's scope of practice are determined by four parameters, and vary state to state:
• Education and experience
• State law
• Facility policy
• Supervising physician's delegatory decisions
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Alabama
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: No

Alaska
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

Arizona
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician can oversee no more than FOUR PA's at one time

Arkansas
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: No; PA's are not authorized to prescribe Schedule II medications
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes, in compliance with Board Policy
Limit on Number of PAs a Physician Can Supervise: No

California
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician can oversee no more than FOUR PA's at one time.

Colorado
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician can oversee no more than FOUR PA's at one time.

Connecticut
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee as many as, but not more than, six PA's concurrently, or the part time equivalent thereof.

Delaware
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FOUR PA's at one time

Florida
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FOUR PA's at one time

Georgia
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: No; Formulary of the Board
Scope of Practice Determination: Determined by State Medical Board
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FOUR PA's at one time

Hawaii
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FOUR PA's at one time

Idaho
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FOUR PA's at one time

Illinois
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; a physician can oversee no more than TWO PA's at one time

Indiana
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than TWO PA's at one time

Iowa
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: No; PA's may prescribe Schedule II medications, excluding depressants
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No, determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than TWO PA's at one time

Kansas
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than THREE PA's at one time

Kentucky
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: No; A PA may not prescribe OR administer Scheduled drugs
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FOUR PA's at one time

Louisiana
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than TWO PA's at one time. A Physician acting as a Locum Tenens Supervisor may oversee no more than FOUR PA'S at one time.

Maine
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

Maryland
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FOUR PA's at one time. Limitation does not apply to PAs practicing in hospitals, correctional facilities, detention centers, or public health facilities.

Massachusetts
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

Michigan
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

Minnesota
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

Mississippi
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: No

Missouri
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: No; PA's with a certificate of controlled substance prescriptive authority may prescribe Schedule III – V medications with restricted authority in Schedule II when delegated in a supervision agreement.
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than THREE PA's at one time. Limitation does not apply to Physicians supervising hospital employed PA's.

Montana
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: No

Nebraska
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than TWO PA's at one time. Board may grant exceptions.

Nevada
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than THREE PA'S or APRN's at one time. Board may grant exceptions.

New Hampshire
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: Yes
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; a Physician may oversee no more than FOUR PA's at one time

New Jersey
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; a Physician may oversee no more than FOUR PA's at one time

New Mexico
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No provision
Limit on Number of PAs a Physician Can Supervise: No

North Carolina
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

North Dakota
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

Ohio
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than THREE PA's at one time. Limitation does not apply to services performed in a hospital.

Oklahoma
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: No; Board defines scope
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FOUR PA's at one time, unless he or she is a Medical Director or supervising physician of a state institution.

Oregon
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

Pennsylvania
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FOUR PA's at one time

Rhode Island
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

South Carolina
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than THREE PA's at one time. Board may grant exceptions.

South Dakota
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; Oversight of more than ONE PA requires application and approval of the board. The board may establish the number of PA's (up to FOUR full time employed) to be overseen by a Physician upon determination that adequate supervision will exist under the Physician's proposed arrangement.

Tennessee
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: No

Texas
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than a combined number of SEVEN APRN's and PA's, or the full time equivalent of SEVEN APRN's and PA'S

Utah
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FOUR PA's at one time. Board may grant exceptions.

Vermont
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

Virginia
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than SIX PA's at one time

Washington
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than THREE PA's working remotely, or more than the physician can adequately supervise. Board may grant exceptions.

West Virginia
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: No; State imposes restrictions on prescribing Controlled Substances and certain other classes of drugs. Schedule III drugs may be prescribed with limitations on supply and refill.
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: No; determined by law
Co Signature Requirements Determined at Practice Level: No; determined by law
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than FIVE PA's at one time; exceptions apply for physicians or PA's employed by or on behalf of a hospital.

Wisconsin
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: Determined by law
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: No

Wyoming
Licensure as the Regulatory Term: Yes
Full Prescriptive Authority: Yes
Scope of Practice Determination: On site between Physician and PA
Adaptable Supervision Requirements: Yes
Co Signature Requirements Determined at Practice Level: Yes
Limit on Number of PAs a Physician Can Supervise: Yes; A physician may oversee no more than THREE PA's at one time. Board may grant exceptions

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