Delaware PA Collaboration Requirements Summary

Delaware requires every PA to work with a collaborating physician, and it frames the relationship as a genuine two-way process rather than one-directional oversight: the physician and the PA jointly contribute to evaluating and managing patients, each acting within what they are individually licensed and trained to do. Physician involvement is standard — no on-site hours, no required meeting schedule, and no prescribed chart review count, but the physician cannot be involved in patient care in name only and must be reachable electronically. The relationship runs on a written collaborative agreement that stays at the PA’s primary practice location rather than being filed with the board. There is no experience threshold that reduces oversight over time. This page covers Delaware’s rules on the collaborative relationship, the written collaborative agreement, board filing, ongoing compliance, prescribing, and specialty and telehealth requirements.

Source: Del. Code Ann. tit. 24 1770A(2)

Type of Collaborative Relationship

Delaware requires a collaborating physician for every PA, and defines that relationship as a joint process rather than direct supervision. The physician must be available for consultation and must be genuinely involved — Delaware states plainly that a collaborating physician may not be involved in patient care in name only and must be involved in active patient care on a regular basis. There is no path to reduced supervision or independent practice for PAs in Delaware; the requirements are the same at every experience level.

Source: Del. Code Ann. tit. 24 1771(d)

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

A PA’s scope in Delaware is identified in the written collaborative agreement and must match the PA’s level of education, training, and experience. Delaware puts that obligation on the physician-PA team jointly, and the PA performs actions they are individually licensed to perform.

Do PAs need a collaborating physician in Delaware?

Yes. A PA must have a collaborating physician who oversees patient services, jointly contributes to patient care, and is available for consultation.

Can PAs practice independently in Delaware?

No. Delaware sets no hour count or experience threshold that leads to reduced supervision or independent practice, and the collaborating physician must remain actively involved in patient care.

How many PAs can a physician collaborate with in Delaware?

Four at any given time, unless a Board regulation changes that number. The limit does not apply where the physician and the PA practice in the same physical office or facility building — an emergency department, for example — as long as there is active physician coverage.

Who can be a collaborating physician in Delaware?

The collaborating physician must be able to jointly contribute to the care the PA is providing, which in practice means practicing in the same or a similar specialty. Delaware defines collaboration as a process in which the physician and the PA each perform actions they are individually licensed for and have the education, training, and experience to perform.

Are there proximity or in-person requirements in Delaware?

No, Delaware sets no distance, travel, or routine on-site presence requirement. The collaborating physician’s constant physical presence in the practice setting is not required, provided the physician is readily accessible by some form of electronic communication. Acupuncture is the exception: a PA may administer it only within the physician’s office while the physician is physically present and immediately available.

Collaboration Agreement Requirements

Delaware’s written agreement is called a written collaborative agreement, and it must cover three things: the PA’s scope of practice, the PA’s relationship with and access to the collaborating physician, and the process for evaluating the PA’s performance. Responsibility for creating it sits with the physician-PA team or the hospital, clinic, medical group, or other facility. It must be kept on file at the primary location where the PA provides care and made available to the Board or the Council on request. The state does not provide a template.

Source: Del. Code Ann. tit. 24 1771(a),(b)

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

Three things: the PA’s identified scope of practice, the relationship with and access to the collaborating physician, and a process for evaluating the PA’s performance. The scope of practice must be appropriate to the PA’s education, training, and experience. Delaware does not provide a state template.

What is the collaborative agreement called in Delaware?

It is called a written collaborative agreement.

Who has to sign the collaborative agreement in Delaware?

Delaware sets no signature requirement for the written collaborative agreement. Responsibility for creating it rests with the physician-PA team or with the facility where the PA works.

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

Delaware sets no review or renewal schedule for the written collaborative agreement.

Is a backup physician required in Delaware?

No, Delaware sets no backup or alternate physician requirement.

Board Filing Requirements

Delaware requires no board filing for the collaborative relationship. The written collaborative agreement is kept on file at the PA’s primary practice location and produced to the Board or the Council on request, rather than submitted. There is no recurring filing and no termination notice requirement; the one filing that does come up is the application a PA submits for a state controlled substance registration.

Source: Del. Code Ann. tit. 24 1771(b)

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

No. The written collaborative agreement is kept at the primary location where the PA provides care and made available to the Board or the Council on request. A PA seeking a state controlled substance registration does have a separate application to submit.

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

There is nothing to file for the collaborative relationship, so no waiting period applies. A PA needs a Delaware license, a collaborating physician, and a written collaborative agreement on file at the practice location.

What are the termination and notice requirements in Delaware?

Delaware sets no termination or notice requirement when a collaborative relationship ends.

Collaboration Compliance

Delaware sets no fixed numbers for ongoing compliance — no required meeting cadence, no chart review count, no co-signature requirement, and no records retention period. What it requires instead is genuine involvement: the collaborating physician may not be involved in patient care in name only, must be involved in active patient care on a regular basis, and must be available for consultation during a patient encounter when that is necessary.

Source: 24 Del. Admin. Code 1700-13.1.1.7.1

How many charts must a collaborating physician review in Delaware?

Delaware prescribes no chart review count or cadence. The collaborating physician must be involved in active patient care on a regular basis rather than in name only, and must be available for consultation during the patient encounter when needed. Chart co-signature is not required.

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

Delaware sets no required meeting cadence. The physician must be readily accessible by some form of electronic communication and genuinely involved in active patient care on a regular basis. The written collaborative agreement must define the PA’s access to the physician and the process for evaluating the PA’s performance.

How long must collaboration records be kept in Delaware?

Delaware sets no retention period for collaboration records. The written collaborative agreement itself must be kept on file at the primary location where the PA provides care.

Prescribing Rules

Prescribing in Delaware is a medical service the collaborating physician delegates, and it is specific to that physician’s practice. Controlled-substance prescribing requires the PA to register with the federal DEA and use that DEA number on controlled-substance prescriptions, plus register with the state every two years. Delaware’s master regulatory data does not break prescribing authority down by drug schedule.

Source: 24 Del. Admin. Code 1700-13.1.1

Can a PA prescribe controlled substances in Delaware?

Yes, as delegated by the collaborating physician and within that physician’s practice. The PA must register with the federal DEA and use that DEA number for controlled-substance prescriptions, and must register with the Secretary of the Department of Health and Social Services every two years. Delaware adds no heightened supervision requirement specific to controlled substances.

Can a PA prescribe Schedule II drugs in Delaware?

Delaware’s master regulatory data does not address drug schedules individually. Prescribing authority is delegated by the collaborating physician and is specific to that physician’s practice, and controlled-substance prescribing requires both federal DEA and state registration.

What schedule drugs can a PA prescribe in Delaware?

Delaware defines prescribing authority by delegation rather than by schedule. What a PA may prescribe is what the collaborating physician delegates, limited to that physician’s own practice, with the required DEA and state registrations in place for controlled substances.

Does a PA need a DEA license in Delaware?

Yes, a federal DEA registration is required, and the PA must use that DEA number on controlled-substance prescriptions. The PA must also register with the state every two years, and Delaware references a Division of Professional Regulation registration as well. There are no prescription pad requirements.

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

No. Prescriptive authority is a delegated medical service, meaning the collaborating physician must delegate it, and it is limited to that physician’s own practice area.

Specialty & Telehealth Requirements

Delaware sets no telehealth-specific requirements for PAs but does impose detailed requirements on PAs who administer acupuncture. Standard collaboration, agreement, and prescribing rules apply otherwise, including the requirement that the physician be readily accessible electronically.

Source: 24 Del. Admin. Code 1700-13.1.1.7.3

Are there telehealth or telemedicine requirements for PAs in Delaware?

Delaware sets no telehealth-specific requirement for PAs in the master regulatory data. Electronic communication is how the collaborating physician satisfies the requirement to be readily accessible to the PA.

Are there specialty-specific requirements for PAs in Delaware?

Yes, acupuncture carries significant additional requirements. The physician must personally evaluate the patient and determine acupuncture is appropriate before a PA begins treatment, must request each subsequent treatment, and both the physician and the PA must be proficient in acupuncture. The PA may administer treatment only within the physician’s office while the physician is physically present and immediately available for consultation.