Louisiana PA Collaboration Requirements Summary

Louisiana requires every PA to practice under a collaborating physician — the state’s term is “supervising physician” — and physician involvement is high. Supervision means the physician gives informed agreement to the PA’s actions, either before or after the fact, or the PA acts under written clinical practice guidelines the physician has set. PAs cannot practice independently in Louisiana, and there is no hours- or years-based path to reduced supervision. The PA files a notice of intent to practice before starting, and the collaborating physician registers with the board; prescriptive authority requires separate board approval. This page covers Louisiana’s rules on supervision, the collaborative agreement, board filing, ongoing compliance, prescribing, and specialty and telehealth requirements.

Source: La. Admin. Code § 1503 (Supervision)

Type of Collaborative Relationship

Louisiana requires PAs to practice under a collaborating physician who accepts responsibility for the care the PA provides. Physician involvement is high: the physician must be reachable by phone or another telecommunications device at all times, and must give informed agreement to the PA’s actions or set written clinical practice guidelines the PA follows. There is no route to independent practice and no transition to reduced supervision.

Source: La. Admin. Code § 1503 (Supervision)

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

A PA’s scope is set by what the collaborating physician delegates, carried out under written clinical practice guidelines or protocols. Those guidelines must direct the PA to contact the physician whenever there is a question about what to do or when the protocol does not cover the clinical situation. Prescribing is likewise limited to what the physician delegates.

Do PAs need a collaborating physician in Louisiana?

Yes. Every PA must have a registered collaborating physician, and the PA must file a notice of intent to practice identifying that physician before starting practice.

Can PAs practice independently in Louisiana?

No. Louisiana requires physician supervision at all times, and there is no independent or autonomous practice option for PAs and no hours-based transition to reduced supervision.

How many PAs can a physician collaborate with in Louisiana?

Up to eight. A physician may not serve as primary supervising physician for more than eight PAs.

Who can be a collaborating physician in Louisiana?

A physician licensed in Louisiana with at least three years of active practice after earning their MD or DO degree, and who is not currently in a residency or other postgraduate training program. To delegate prescribing, the physician must also be actively engaged in clinical practice and patient care. Louisiana’s registration rules also recognize a locum tenens supervising physician, who must meet the same eligibility standards and register with the board.

Are there proximity or in-person requirements in Louisiana?

Yes, in one situation: if the PA has prescriptive authority and their primary practice site is different from the physician’s, the physician must visit the PA’s site at least weekly during regular office hours. During those visits the physician consults with the PA on any issues or complications relating to the PA’s prescriptions. No proximity rule applies when the PA and physician share the same primary practice site.

Collaboration Agreement Requirements

Louisiana requires a written agreement between the PA and the collaborating physician, signed by both, kept on file at the practice site, and updated annually. The state supplies the notice of intent to practice form and a clinical practice guidelines form that together meet the content requirements. No backup physician is required.

Source: LSA-R.S. 37:1360.29(A)(4)

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

The agreement must confirm the PA and physician can reach each other electronically, allow the PA to act with the physician’s informed agreement (before or after the service, or under approved clinical guidelines), require annual review of the level and method of supervision, and state that the physician will supervise in line with the regulations. It must also include guidelines or protocols directing the PA to contact the physician when the PA is uncertain what to do or the protocol does not address the situation. Louisiana provides forms that satisfy these requirements.

What is the collaborative agreement called in Louisiana?

Louisiana calls it a written agreement. The clinical practice guidelines or protocols the physician sets for the PA are part of that arrangement.

Who has to sign the collaborative agreement in Louisiana?

Both the collaborating physician and the PA must sign.

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

Annually. The agreement must be updated each year, and the level and method of supervision must be documented and reviewed annually to reflect how sick the patients are and what procedures are involved.

Is a backup physician required in Louisiana?

No — Louisiana sets no backup physician requirement.

Board Filing Requirements

Louisiana does not require the written agreement itself to be filed with the board — it stays on file at the practice site — but the PA must file a notice of intent to practice before starting, and the collaborating physician must register with the board. The PA may begin practicing once that notice is filed, but prescriptive authority and a physician’s first supervising-physician registration both require board approval first. Both clinicians must notify the board within 15 days when the arrangement ends.

Source: LSA-R.S. 37:1360.30(A)

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

No, the written agreement is not filed with the board. It is kept on file at the practice site and made available to the board on request. The PA must, however, file a notice of intent to practice identifying each collaborating physician before beginning practice, and the physician must notify the board of the intent to supervise and submit a statement that they will supervise in line with board rules and retain professional and legal responsibility for the PA’s care.

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

Generally yes — the PA’s notice of intent to practice is effective on filing. Two things do require board approval first: the PA’s registration for prescriptive authority, and a physician’s first-time registration as a supervising physician. After that first registration, a physician does not re-register for each new PA; the PA’s notice of intent to practice serves as notice to the board.

What are the termination and notice requirements in Louisiana?

Both the PA and the collaborating physician must notify the board in writing within 15 days when the supervision relationship ends. The PA must also notify the board within 15 days of any change in or addition to their collaborating physicians. Separately, the physician must confirm their registration information with the board annually and report changes to filed information within 15 days. Louisiana provides no grace period for an unanticipated termination.

Collaboration Compliance

Once the collaboration is active, the collaborating physician must run monthly chart review under a written performance plan, stay reachable by phone or other telecommunications device, and keep the review records for three years. Louisiana sets no general meeting cadence, but weekly on-site visits apply to prescribing PAs at a separate practice site. Chart co-signature is not required.

Source: La. Admin. Code § 4512(A)

How many charts must a collaborating physician review in Louisiana?

At least 50% of the PA’s patient encounters, reviewed monthly, during the PA’s first 12 months of supervised practice after passing the credentialing exam and during the first 6 months after moving into an entirely new field of practice — but only when the PA’s primary practice site differs from the physician’s. When the two work at the same primary practice site, routinely confer about patient care, and both document in the charts kept there, that 50% requirement is considered met. For all other PAs, the physician reviews whatever monthly number of charts they judge appropriate; if the PA prescribes, the review must cover a representative sample of the PA’s prescriptions, which means charts involving controlled substances get reviewed to some extent.

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

Louisiana sets no general meeting cadence. The one exception: if the PA prescribes and has a primary practice site different from the physician’s, the physician must visit that site at least weekly during regular office hours. Outside of that, the physician and PA must simply be able to reach each other by telephone or another telecommunications device.

How long must collaboration records be kept in Louisiana?

Three years. Records and documentation of the performance plan for each PA — including a list of the charts and other items reviewed — must be kept for three years and made available to board representatives on request. The level and method of supervision must also be documented and reviewed annually.

Prescribing Rules

PAs in Louisiana may prescribe, order, and administer drugs to the extent the collaborating physician delegates that authority, and the PA must be separately approved by the board for prescriptive authority before writing any prescription. Controlled-substance prescribing requires both a controlled dangerous substance license from the Louisiana Board of Pharmacy and federal DEA registration. Prescribing is never independent of the physician — the scope is whatever the physician has delegated.

Source: LSA-R.S. 37:1360.31(C)

Can a PA prescribe controlled substances in Louisiana?

Yes, when the collaborating physician delegates that authority and the PA holds the required credentials. The PA must obtain a controlled dangerous substance license from the Louisiana Board of Pharmacy and register with the federal DEA. The collaborating physician must also hold an unrestricted permit or license to prescribe controlled substances from Louisiana’s Office of Narcotics and Dangerous Drugs and be registered with the DEA without restriction.

Can a PA prescribe Schedule II drugs in Louisiana?

Yes, if the collaborating physician delegates Schedule II authority. Louisiana’s prescriptive authority rules address delegation of Schedules II, III, IV, and V together, with the same Board of Pharmacy license and DEA registration requirement.

What schedule drugs can a PA prescribe in Louisiana?

Schedules II through V, plus non-controlled (legend) drugs and medical devices — in each case only to the extent the collaborating physician delegates. Louisiana’s master rules set no additional schedule-by-schedule limits, day-supply caps, or refill restrictions for PAs.

Does a PA need a DEA license in Louisiana?

Yes. A PA authorized to prescribe controlled substances must register with the U.S. Drug Enforcement Administration, and must also hold a controlled dangerous substance license from the Louisiana Board of Pharmacy. The collaborating physician needs their own DEA registration as well.

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

No. A PA may prescribe only to the extent the collaborating physician has delegated that authority, and the physician’s delegation of prescriptive authority must be registered with and approved by the board for each PA. There are no prescription pad requirements beyond that.

Specialty & Telehealth Requirements

Louisiana sets no PA-specific telehealth requirement and no specialty-specific requirement in its master rules — the standard supervision, agreement, filing, and prescribing rules apply across settings and specialties. One practical note: Louisiana has not addressed whether a video visit can satisfy the weekly on-site visit required for a prescribing PA at a separate practice site.

Are there telehealth or telemedicine requirements for PAs in Louisiana?

No — Louisiana sets no PA-specific telehealth or telemedicine requirement. A PA practicing telehealth only, or a PA who does not prescribe, is not subject to the weekly on-site visit rule that applies to prescribing PAs at a separate practice site. Louisiana gives no guidance on whether a video visit can satisfy that weekly visit where it does apply.

Are there specialty-specific requirements for PAs in Louisiana?

No — Louisiana sets no specialty-specific requirements for PAs. The one specialty-adjacent rule is timing-based rather than field-based: a PA moving into an entirely new field of practice, such as from primary care to a surgical specialty, triggers six months of heightened monthly chart review when their practice site differs from the physician’s.