Indiana PA Collaboration Requirements Summary

Indiana requires every PA to work under a written collaborative agreement with a collaborating physician who oversees the PA’s activities and accepts responsibility for the medical services the PA renders. Involvement is high and runs on a clock: patient encounters must be reviewed within 10 business days, and the physician must be immediately reachable electronically whenever they are not physically present. The collaborative agreement is filed with the Board and must be resubmitted whenever it is amended, and it has to be updated annually. When a PA can begin depends on what is being filed — a new licensee waits for both a license and an agreement on file, while a PA seeking prescriptive authority can work as a PA but must wait for Board approval before prescribing. This page covers Indiana’s rules on collaboration, the collaborative agreement, board filing, ongoing compliance, prescribing, and specialty and telehealth requirements.

Source: IC § 25-27.5-2-4.9(a)

Type of Collaborative Relationship

Indiana requires PAs to practice under a collaborating physician who accepts responsibility for the PA’s medical services, with no route to independent practice. Involvement is high: the physician must stay immediately reachable when off-site, be able to come see the patient within a medically appropriate time frame, and review patient encounters on a 10-business-day clock. A PA’s authority is the set of tasks delegated in the written collaborative agreement, and a physician may collaborate with no more than four PAs at the same time.

Source: IC § 25-27.5-6-4(a)

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

A PA’s scope of practice is the set of tasks the collaborating physician delegates in the written collaborative agreement. Delegation must be appropriate to the PA’s level of competence and must fall within the collaborating physician’s own scope of practice. The physician and PA together must also ensure the PA’s scope of practice is identified and that the relationship with and access to the physician is defined.

Do PAs need a collaborating physician in Indiana?

Yes. Indiana defines collaboration as the physician overseeing the PA’s activities and accepting responsibility for the medical services the PA renders, so a collaborating physician is required at all times.

Can PAs practice independently in Indiana?

No. Indiana has no independent or autonomous practice option for PAs, and no hours- or years-based pathway that reduces oversight over time.

How many PAs can a physician collaborate with in Indiana?

No more than four at the same time. A physician may enter into collaborative agreements with more than four PAs, but may not actually collaborate with more than four at any one time.

Who can be a collaborating physician in Indiana?

The collaborating physician must be a physician licensed by the Indiana board who collaborates with and is responsible for the PA. Indiana sets no specialty-matching requirement, but there is a practical limit: the physician can only delegate tasks that fall within their own scope of practice.

Are there proximity or in-person requirements in Indiana?

No — Indiana sets no geographic, travel, or on-site presence requirement. What Indiana requires instead is availability: when the collaborating physician or a physician designee is not physically present where the PA is working, they must be able to personally ensure proper patient care, be immediately available through telecommunications or other electronic means, and be able to see the patient within a medically appropriate time frame for consultation if the patient or PA requests it.

Collaboration Agreement Requirements

Indiana’s written agreement is called a collaborative agreement, and the state provides a template. Both the collaborating physician and the PA sign it. It must be updated annually, made available to the Board on request, and resubmitted to the Board whenever it is amended. Indiana requires no on-site storage and no backup physician.

Source: IC § 25-27.5-5-2(e)

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

The agreement must be in writing and include all the tasks the collaborating physician delegates to the PA, the collaborative plan including the emergency procedures the PA must follow, the protocol the PA follows when prescribing a drug, and the names of medical devices the PA is delegated to prescribe. It must also carry the collaborating physician’s name, address, and phone number, and describe the settings in which the PA will work. Finally, it must state that the physician will work in collaboration with the PA and retains responsibility for the care the PA renders — and every agreement submitted to the Board must address chart review.

What is the collaborative agreement called in Indiana?

It is called a collaborative agreement. Indiana provides a template.

Who has to sign the collaborative agreement in Indiana?

The collaborating physician and the PA must both sign.

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

Annually. The collaborative agreement must be updated each year and made available to the Board on request. Any amendment must also be resubmitted to the Board.

Is a backup physician required in Indiana?

No — Indiana sets no backup or alternate physician requirement. The collaborative agreement must, however, set out the emergency procedures the PA is to follow. Indiana provides no grace period if the collaborating physician unexpectedly becomes unavailable.

Board Filing Requirements

Indiana requires the collaborative agreement to be submitted to the Board, and the collaborating physician must separately register their intent to collaborate with a PA. Whether a PA can start right away depends on what is being filed — new licensure and prescriptive authority follow different rules. Amendments must be resubmitted, and termination carries a 15-day notice deadline.

Source: IC § 25-27.5-5-2(f)

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

Yes. The collaborating physician must submit the collaborative agreement to the Board and must also register with the Board their intent to enter into a collaborative agreement with a PA. A PA beginning practice with a new or additional collaborating physician has 30 days to complete a change or addition application.

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

It depends on what is being filed. A PA applying for an initial license cannot practice until the license is issued and a collaborative agreement is on file. A PA applying for prescriptive authority may practice as a licensed PA with their collaborating physician, but cannot use that prescriptive authority until the Board issues an approval letter.

What are the termination and notice requirements in Indiana?

The collaborating physician must notify both the Board and the committee within 15 days that the collaborating relationship has ended, and must state the reason for the termination. Indiana provides no grace period allowing the PA to keep practicing while a new collaborating physician is arranged.

Collaboration Compliance

Indiana’s ongoing obligations center on chart review against a fixed deadline: patient encounters must be reviewed within 10 business days. A minimum percentage applies in the first year, and after that the collaborating physician sets the percentage in the agreement. Alongside that, the physician must remain immediately reachable when off-site. Indiana requires no meeting cadence, no chart co-signature, and no separate documentation or retention rule.

Source: IC § 25-27.5-6-1(b),(c)

How many charts must a collaborating physician review in Indiana?

Review must happen within 10 business days of the patient encounter, and at least 10% of records must be reviewed in the first year. That first-year minimum covers the patient records for any prescription the PA prescribed or administered; for each subsequent year, the percentage is whatever the collaborating physician determines is reasonable for the particular practice setting and the PA’s level of experience, as stated in the collaborative agreement. Chart review must be addressed in every collaborative agreement submitted to the Board, and separate chart co-signature is not required.

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

Indiana sets no specific meeting requirement. It does set an availability standard: when the collaborating physician or physician designee is not physically present, they must be immediately available through telecommunications or other electronic means and able to see the patient within a medically appropriate time frame for consultation, if the patient or PA requests it.

How long must collaboration records be kept in Indiana?

Indiana sets no specific retention period and no separate supervision documentation requirement. The collaborative agreement must be updated annually and made available to the Board on request.

Prescribing Rules

A collaborating physician in Indiana may delegate authority to prescribe only legend drugs and medical devices that fall within the physician’s own scope of practice, and the collaborative agreement must specify the protocol the PA follows when prescribing. Controlled substances require two credentials: an Indiana controlled substance registration and a federal DEA registration. Indiana also maintains detailed rules governing PAs who prescribe opioids.

Source: IC § 25-27.5-5-6(c),(d)

Can a PA prescribe controlled substances in Indiana?

Yes, where the collaborating physician delegates that authority. The PA must obtain both an Indiana controlled substance registration and a federal DEA registration. Prescriptive authority also has to be approved by the Board before the PA uses it.

Can a PA prescribe Schedule II drugs in Indiana?

Yes — Indiana’s PA rules set no schedule-based restriction on PAs. What a PA may prescribe is bounded by the collaborating physician’s own scope of practice and by the prescribing protocol written into the collaborative agreement. Indiana does maintain separate, detailed requirements for PAs prescribing opioids.

What schedule drugs can a PA prescribe in Indiana?

Legend drugs and medical devices within the collaborating physician’s scope of practice, plus controlled substances where that authority is delegated and the PA holds both registrations. Indiana sets no PA-specific schedule list and no special prescription pad requirements. Opioid prescribing carries its own set of rules.

Does a PA need a DEA license in Indiana?

Yes — a PA delegated authority to prescribe controlled substances must obtain a federal DEA registration. Indiana additionally requires an Indiana controlled substance registration, so both credentials are needed.

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

No. Prescriptive authority is delegated by the collaborating physician, capped by that physician’s own scope of practice, and exercised according to the protocol written into the collaborative agreement. Individual prescriptions do not require co-signature, but a percentage of prescription-related patient records must be reviewed within 10 business days.

Specialty & Telehealth Requirements

Indiana sets no telehealth-specific or specialty-specific requirements for PAs. The standard collaboration, agreement, filing, compliance, and prescribing rules apply the same way regardless of specialty or how care is delivered.

Source: IC § 25-27.5 (Physician Assistants; Indiana sets no specialty- or telehealth-specific provision for PAs)

Are there telehealth or telemedicine requirements for PAs in Indiana?

No — Indiana sets no telehealth-specific requirement for PAs. Indiana’s availability standard is already built around electronic contact: when the collaborating physician is not physically present, being immediately reachable by telecommunications or other electronic means satisfies the requirement.

Are there specialty-specific requirements for PAs in Indiana?

No — Indiana sets no specialty-specific requirement for PAs. Specialty still shapes the arrangement: a collaborating physician may only delegate tasks that fall within their own scope of practice, and may only delegate prescribing for drugs and devices within that scope.