Nevada PA Collaboration Requirements Summary

Nevada requires every PA to have a supervising physician who is responsible for all of the PA’s medical activities, and it is one of the few states with a recurring in-person requirement: at least once a month the physician must spend part of a day at any location where the PA works. There is no written collaborative agreement in Nevada. What replaces it is a quality-of-care program the supervising physician must build and run, covering competency assessment, chart review, referral sampling, and direct observation of the PA with patients. The PA cannot provide medical services until the Board has been notified of the supervisory relationship, and any change in supervision has to be reported within 72 hours. This page covers Nevada’s rules on the supervising relationship, written documentation, board notice, ongoing compliance, prescribing, and specialty and telehealth requirements.

Source: NAC 630.370(1)

Type of Collaborative Relationship

Nevada requires a supervising physician who is responsible for all the medical activities of the PA. Physician involvement is high: the physician must be available to consult whenever the PA is providing services, must run a formal quality-of-care program, and must be physically present at the PA’s practice location at least once a month. Nevada offers no path to reduced supervision or independent practice, and no experience threshold changes any of these requirements.

Source: NAC 630.370(3)

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

A PA’s scope in Nevada is the portion of practice that a supervising physician supervises, as identified in the notice filed with the Board. A PA may have different supervising physicians covering different portions of their practice. The supervising physician is responsible for all of the PA’s medical activities.

Do PAs need a collaborating physician in Nevada?

Yes. A PA may not provide medical services until the Board has been notified of the supervising physician and the portion of the PA’s practice that physician supervises.

Can PAs practice independently in Nevada?

No. Nevada sets no hour count or experience threshold leading to reduced supervision or independence, and the supervising physician remains responsible for all of the PA’s medical activities.

How many PAs can a physician collaborate with in Nevada?

Three at a time, counting PAs and advanced practice registered nurses together. A physician may petition the Board to exceed that limit, but the Board will approve only on satisfactory proof that special circumstances in the physician’s practice make it necessary and that the physician can still supervise the larger number satisfactorily.

Who can be a collaborating physician in Nevada?

A physician who holds an active Nevada license in good standing issued by the Board and who actually practices medicine in Nevada. Specialty matters for coverage: any substitute physician the supervising physician designates must practice medicine in the same specialty as the supervising physician.

Are there proximity or in-person requirements in Nevada?

Yes — at least once a month the supervising physician must spend part of a day at any location where the PA provides medical services. The purpose of that visit is to act as a consultant to the PA and to monitor the quality of care the PA is providing. Outside those visits, the physician must be available at all times the PA is performing medical services to consult, and those consultations may be indirect, including by telephone.

Collaboration Agreement Requirements

Nevada requires no written collaborative agreement. In its place, a physician who supervises a PA must develop and carry out a program to ensure the quality of the care the PA provides, covering five areas: assessing the PA’s medical competency, reviewing and initialing selected charts, assessing a representative sample of the PA’s referrals and consultations, directly observing the PA take a history and examine patients, and keeping accurate records of the program for each PA supervised. Nevada provides no template, sets no signature requirement for that program, sets no on-site storage rule, and sets no review or renewal schedule.

Source: NAC 630.370(5)

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

Nevada requires no collaborative agreement, but the supervising physician’s quality-of-care program must cover five things: an assessment of the PA’s medical competency, review and initialing of selected charts, an assessment of a representative sample of the referrals or consultations the PA makes with other health professionals as the patient’s condition requires, direct observation of the PA taking a medical history from and examining patients representative of the PA’s caseload, and the physician’s maintenance of accurate records and documentation of the program for each PA supervised. Nevada provides no state template.

What is the collaborative agreement called in Nevada?

Nevada has no named collaborative agreement for PAs. The documents that do exist are the Board notice identifying the supervising physician and the portion of practice supervised, and the supervising physician’s quality-of-care program records.

Who has to sign the collaborative agreement in Nevada?

Nevada sets no signature requirement, since no collaborative agreement is required. The notice submitted to the Board does have to carry the signatures of both the PA and the supervising physician.

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

Nevada sets no review or renewal schedule. Any change in the supervision of the PA must be reported to the Board in writing within 72 hours.

Is a backup physician required in Nevada?

Yes, in practice — if the supervising physician is unable to supervise the PA as required, that physician must designate a qualified substitute physician who practices medicine in the same specialty. Nevada does not require the substitute to be named in advance in any document.

Board Filing Requirements

Nevada requires notice to the Board before a PA provides any medical services. On a Board-prescribed form, the PA must report their name and practice location, the name of the supervising physician, and the portion of the PA’s practice that physician supervises, with signatures from both the PA and the physician. Separate forms apply depending on whether the supervising physician holds an MD or a DO license. Changes in supervision must be reported within 72 hours, and terminations immediately.

Source: NAC 630.340(2)

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

No, because Nevada requires no collaborative agreement — but the supervisory relationship itself must be reported. The notice identifies the PA’s name and practice location, the supervising physician, and the portion of the PA’s practice under that physician’s supervision, and must be signed by both.

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

Yes — practice is prohibited only before the Board has been notified. No separate Board approval is required after the notice is submitted.

What are the termination and notice requirements in Nevada?

Both the PA and the supervising physician must immediately notify the Board when supervision terminates. For whatever portion of the PA’s practice that physician supervised, the PA may not provide medical services again until the PA and a supervising physician submit a new notice to the Board. Separately, any change in supervision must be reported in writing within 72 hours, and Nevada allows no grace period for an unexpected termination.

Collaboration Compliance

Nevada’s ongoing obligations run through the supervising physician’s quality-of-care program plus a standing availability requirement. The physician must be available to consult at all times the PA is performing medical services, must review and initial selected charts, must directly observe the PA with patients, and must keep accurate records of the program for each PA supervised. On top of that comes the monthly visit to each location where the PA works.

Source: NAC 630.370(2)

How many charts must a collaborating physician review in Nevada?

There is no fixed count for most PAs — the supervising physician must review and initial selected charts of the PA’s patients. Where the supervising physician is an osteopathic physician, the requirement is specific: review and initial at least 10% of the PA’s patient charts at least four times each year. Chart review sits inside the broader quality-of-care program, which also requires competency assessment, referral sampling, and direct observation.

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

At least monthly in person, at any location where the PA provides medical services. Nevada sets no separate meeting cadence beyond that visit, but the physician must be available to consult at all times the PA is providing services, including indirectly by telephone, and must directly observe the PA taking histories and examining patients as part of the quality-of-care program.

How long must collaboration records be kept in Nevada?

Nevada sets no retention period, but the supervising physician must maintain accurate records and documentation of the quality-of-care program for each PA supervised.

Prescribing Rules

A PA’s controlled-substance prescribing authority in Nevada is limited to the schedules the supervising physician is authorized to prescribe under state and federal law. Both the Board and the supervising physician are required to apply that limit. Nevada adds no further conditions on prescriptive authority and sets no prescription form requirements.

Source: NRS 630.271(2)

Can a PA prescribe controlled substances in Nevada?

Yes, within the schedules the supervising physician is authorized to prescribe under state and federal law. The Board and the supervising physician must both limit the PA’s authority to those schedules. Nevada adds no heightened supervision requirement specific to controlled substances.

Can a PA prescribe Schedule II drugs in Nevada?

It depends on the supervising physician’s own authority. Nevada does not set a schedule-specific ceiling for PAs; instead a PA may prescribe in a schedule only if the supervising physician is authorized to prescribe in that schedule.

What schedule drugs can a PA prescribe in Nevada?

The same schedules the supervising physician is authorized to prescribe. Nevada’s rule is derivative rather than fixed, so a PA’s authority changes with the supervising physician’s authority.

Does a PA need a DEA license in Nevada?

Nevada’s master regulatory data does not address state or federal DEA registration for PAs. What it does establish is that a PA’s controlled-substance authority cannot exceed the schedules the supervising physician is authorized to prescribe under state and federal law.

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

No. A PA’s prescribing authority is defined by and capped at the supervising physician’s own authority, and the physician remains responsible for all of the PA’s medical activities. Nevada does not require prescription-level co-signature.

Specialty & Telehealth Requirements

Nevada’s master regulatory data does not set out telehealth-specific or specialty-specific requirements for PAs. Telehealth does raise one open question: Nevada requires the supervising physician to spend part of a day monthly at any location where the PA provides services, and the rules do not explain how that applies to a PA practicing entirely by telehealth.

Are there telehealth or telemedicine requirements for PAs in Nevada?

Nevada sets no telehealth-specific requirement for PAs in the master regulatory data. The practical issue is the monthly on-site visit: Nevada gives no guidance on how a PA who works only by telehealth satisfies it, though video conferencing may be an option. Routine consultations between the PA and the physician may be indirect, including by telephone.

Are there specialty-specific requirements for PAs in Nevada?

Nevada sets no specialty-specific requirements for PAs in the master regulatory data. Two specialty-related rules do apply: a substitute physician must practice in the same specialty as the supervising physician, and PAs supervised by an osteopathic physician are subject to the 10% quarterly chart review requirement.