Arkansas PA Collaboration Requirements Summary

Arkansas requires every PA to practice under a supervising physician, and supervision must be continuous. Physician involvement is high: the physician does not have to be in the building, but must be available for immediate contact whenever the PA is seeing patients, must review 10% of charts monthly, and must meet with the PA quarterly. PAs cannot practice independently in Arkansas, and the state offers no path to reduced supervision based on hours or years of experience. The PA and physician work under a delegation agreement written on the Board’s own form, which is submitted to the Board as part of PA licensure. This page covers Arkansas’s rules on supervision, the collaborative agreement, board filing, ongoing compliance, prescribing, and specialty and telehealth requirements.

Source: Ark. Code § 17-105-101(5)

Type of Collaborative Relationship

Arkansas requires PAs to work under a supervising physician at all times, and that supervision must be continuous. Physician involvement is high, but the physician’s constant physical presence is not required — the standard is immediate reachability rather than proximity. There is no route to independent practice and no reduced-supervision tier: a physician may directly supervise up to three PAs at one time, and the physician accepts responsibility for the medical services the PA provides.

Source: Arkansas State Medical Board Rule 24(6)

What is a PA’s scope of practice in Arkansas?

A PA’s scope of practice is set by the delegation agreement submitted to and approved by the Arkansas State Medical Board. That agreement spells out the area or type of practice, the practice location, the type and frequency of supervision, and the drug-prescribing authority the physician delegates. A PA’s prescribing authority can never exceed the supervising physician’s own.

Do PAs need a collaborating physician in Arkansas?

Yes. Every PA must have a designated supervising physician, and the delegation agreement naming that physician is part of the PA’s license application. A back-up supervising physician must also be named.

Can PAs practice independently in Arkansas?

No. Arkansas defines supervision as overseeing the PA’s activities and accepting responsibility for the medical services the PA renders, and it requires that supervision of each PA be continuous. There is no independent or autonomous practice option.

How many PAs can a physician collaborate with in Arkansas?

Three at one time. A physician may hold supervising authority over more than three PAs, but may only directly supervise up to three PAs at any one time.

Who can be a collaborating physician in Arkansas?

Any doctor of medicine (MD) or doctor of osteopathy (DO) licensed by the Arkansas State Medical Board. The delegation agreement must also document the physician’s qualifications in the area or type of practice the PA will be working in. Arkansas sets no minimum years-in-practice requirement.

Are there proximity or in-person requirements in Arkansas?

No — Arkansas sets no on-site presence, distance, or travel requirement. The supervising physician’s constant physical presence is not required, as long as the physician and PA can easily reach one another by phone, radio, or other electronic means. The supervising or back-up physician must be available for immediate contact any time the PA is providing care.

Collaboration Agreement Requirements

Arkansas calls the written agreement a delegation agreement, and it must be written on the form issued by the Arkansas State Medical Board rather than drafted from scratch. The form requires nine specific items, including the practice area and location, the type and frequency of supervision, the evaluation process, the delegated prescribing authority, and the named back-up physician. A copy must be kept at the PA’s practice location and the agreement must be updated annually.

Source: Arkansas State Medical Board Rule 24(4)(b)

What must be included in a PA collaborative agreement in Arkansas?

The delegation agreement must cover nine required items: the area or type of practice; the practice location; the supervising physician’s geographic range; the type and frequency of supervision; the physician’s process for evaluating the PA; the supervising physician’s name; that physician’s qualifications in the PA’s practice area; the drug-prescribing authority being delegated; and the name of the back-up physician along with when that physician will be used. Because Arkansas mandates its own form, the content is fixed rather than negotiable.

What is the collaborative agreement called in Arkansas?

It is called a delegation agreement. Arkansas requires it to be written on the form issued by the Arkansas State Medical Board.

Who has to sign the collaborative agreement in Arkansas?

The PA, the supervising physician, and the back-up supervising physician must all sign.

How often must the agreement be reviewed or renewed in Arkansas?

Annually. The delegation agreement must be signed by both the physician and the PA and updated every year.

Is a backup physician required in Arkansas?

Yes. The delegation agreement must name the back-up supervising physician (or physicians) and describe the circumstances in which the back-up will be used.

Board Filing Requirements

Yes — the delegation agreement must be filed with the Arkansas State Medical Board, and it is submitted as part of the PA’s license application. A new signed delegation agreement must be resubmitted whenever a supervising or back-up supervising physician is added or changed, and the PA must notify the Board of any such change within 10 calendar days. No additional documents are required beyond the agreement itself.

Source: Arkansas State Medical Board Rule 24(2)(j)

Do you have to file the collaborative agreement with the board in Arkansas?

Yes. Submitting a delegation agreement that lays out the PA’s scope of practice and the physician’s program of evaluation and supervision is one of the requirements for obtaining an Arkansas PA license. A signed delegation agreement must be resubmitted to add or change a supervising or back-up supervising physician.

Can a PA start practicing as soon as they file in Arkansas?

Arkansas’s rules do not directly address this. The delegation agreement is filed as part of the PA license application, so the ability to practice is tied to licensure rather than to a separate agreement-approval step.

What are the termination and notice requirements in Arkansas?

The PA must notify the Arkansas State Medical Board within 10 calendar days of any change in or addition to their supervising physicians. Arkansas provides no grace period for an unanticipated termination, so a PA who loses their supervising physician has no built-in window to keep practicing.

Collaboration Compliance

Once the delegation agreement is active, the supervising physician must review 10% of the PA’s charts every month, review every chart in which a Schedule II medication was prescribed, and hold documented quarterly meetings with the PA. The physician or back-up physician must be reachable for immediate contact whenever the PA is treating patients, and supervision must be continuous. Chart co-signature is not required.

Source: Arkansas State Medical Board delegation agreement form (state template)

How many charts must a collaborating physician review in Arkansas?

10% of charts each month, as a representative sample of patient records. On top of that, every patient who receives a Schedule II prescription must have their chart reviewed by the supervising or back-up supervising physician. Arkansas does not require the physician to co-sign the PA’s charts.

How often must a PA and collaborating physician meet in Arkansas?

Quarterly. The meeting must be documented, including the topics discussed.

How long must collaboration records be kept in Arkansas?

Arkansas sets no specific retention period for collaboration records. The state does require that a copy of the approved delegation agreement be kept at the PA’s practice location and that quarterly meetings be documented.

Prescribing Rules

PAs in Arkansas may prescribe, including controlled substances, but only to the extent the supervising physician delegates that authority in the delegation agreement — and a PA’s prescribing authority can never exceed the physician’s own. Schedule II prescribing is narrowly limited to short opioid courses and physician-initiated stimulant continuations. A PA who prescribes controlled substances must register with the federal DEA under its Mid-Level Practitioner Registry; Arkansas does not require a separate state DEA registration or any additional state prescribing credential.

Source: Arkansas State Medical Board Rule 24(5)(a)

Can a PA prescribe controlled substances in Arkansas?

Yes, when the supervising physician delegates that authority in the delegation agreement. A PA who prescribes controlled substances must register with the federal DEA through its Mid-Level Practitioner Registry. The PA’s prescribing authority can never exceed the supervising physician’s.

Can a PA prescribe Schedule II drugs in Arkansas?

Yes, but only in two narrow situations: an opioid prescription for a five-day supply or less, or a stimulant prescription that continues treatment a physician originally started — where the physician evaluated the patient within the previous six months and the PA’s prescription treats the same condition. These Schedule II limits do not apply to hydrocodone products that were previously classified as Schedule III.

What schedule drugs can a PA prescribe in Arkansas?

Schedules II through V, plus non-controlled drugs, to the extent the supervising physician delegates that authority — with Schedule II sharply restricted as described above. A PA’s prescribing authority is capped at the supervising physician’s own level of prescriptive authority.

Does a PA need a DEA license in Arkansas?

Yes, for controlled substances — a federal DEA registration under the Mid-Level Practitioner Registry is required. Arkansas does not require a separate state DEA registration or an additional state prescribing credential.

Can a PA prescribe independently (without physician sign-off) in Arkansas?

No. Prescribing authority is delegated by the supervising physician through the delegation agreement and cannot exceed that physician’s own authority. Every prescription the PA writes must also be recorded in the patient’s chart with the medication details, the PA’s signature, and the supervising physician’s printed name.

Specialty & Telehealth Requirements

Arkansas’s PA rules contain no telehealth-specific and no specialty-specific requirements. The state’s standard supervision, delegation agreement, filing, compliance, and prescribing rules apply regardless of practice setting or specialty.

Source: Arkansas State Medical Board Rule 24 — no telehealth- or specialty-specific provision

Are there telehealth or telemedicine requirements for PAs in Arkansas?

No — Arkansas sets no telehealth-specific requirement for PAs in its PA rules. The general supervision standard still applies: the supervising or back-up physician must be available for immediate contact any time the PA is providing care.

Are there specialty-specific requirements for PAs in Arkansas?

No — Arkansas sets no specialty-specific requirement for PAs. The delegation agreement must, however, document the supervising physician’s qualifications in the area or type of practice the PA will be working in.