Ohio PA Collaboration Requirements Summary

Ohio requires every PA to work under a collaborating physician through a written supervision agreement, and that agreement must state plainly that the physician is legally responsible for the PA’s services. Physician involvement is standard once the PA is established, but it starts high for prescribing: the first 500 hours of delegated prescribing must happen with the physician on-site. After that, the physician does not have to be in the building — they must be continuously available for direct communication, either in person or by real-time contact from a distance that still allows proper care. Nothing is filed with the State Medical Board of Ohio; the supervision agreement stays in the physician’s and the PA’s own records.

Source: Ohio Rev. Code § 4730.19(A)

Type of Collaborative Relationship

Ohio requires PAs to practice under a supervising physician at all times, with no route to independent practice. Day-to-day involvement is standard once the PA is past the first 500 hours of prescribing, which must be completed on-site; after that the physician must simply stay continuously available for direct communication. A PA’s authority comes from what the physician delegates in the supervision agreement, and one physician may supervise up to five PAs at a time.

Source: Ohio Rev. Code § 4730.21(B)

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

A PA’s scope of practice is what the supervising physician delegates in the written supervision agreement. For a PA practicing outside a health care facility, the agreement must spell out the PA’s responsibilities, any limits on them, and when the PA must refer a patient to the physician. For a PA practicing inside a hospital or ambulatory surgical facility, the agreement requires the PA to practice according to that facility’s policies.

Do PAs need a collaborating physician in Ohio?

Yes. A PA must have a written supervision agreement with a supervising physician, and that physician assumes legal responsibility for the services the PA provides.

Can PAs practice independently in Ohio?

No. Ohio has no independent or autonomous practice option for PAs. Completing the 500-hour on-site prescribing period lifts the on-site requirement, but a supervising physician and a supervision agreement are still required afterward.

How many PAs can a physician collaborate with in Ohio?

A physician may supervise no more than five PAs at any one time. There is no cap on how many supervision agreements a physician may hold overall — the limit is on simultaneous supervision. A PA may enter into supervision agreements with any number of supervising physicians.

Who can be a collaborating physician in Ohio?

Ohio sets no specific qualification requirements for a supervising physician. If the supervising physician designates alternate supervising physicians, their names, business addresses, and business telephone numbers must be listed in the supervision agreement.

Are there proximity or in-person requirements in Ohio?

Yes, but only at the start of prescribing. The PA’s first 500 hours of delegated prescribing must be under on-site supervision. Outside of that period, the physician must be continuously available for direct communication.

Collaboration Agreement Requirements

Ohio’s written agreement is called a supervision agreement, and the state provides fill-in templates rather than leaving the format open — one for hospitals and ambulatory surgical facilities, and one for all other settings. The physician and the PA both sign it, and the agreement must state that the physician is legally responsible for the PA’s services. Ohio sets no review or renewal schedule, but both parties must keep a copy in their own records.

Source: Ohio Rev. Code § 4730.19(B)

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

Every supervision agreement must state that the physician agrees to supervise the PA, that the PA agrees to practice under that supervision, and that the physician is legally responsible and assumes legal liability for the PA’s services. For a PA practicing inside a health care facility, it must also require the PA to follow that facility’s policies. For a PA practicing outside one, it must set out the physician’s responsibilities, the PA’s responsibilities and any limits on them, when the PA must refer a patient to the physician, the physician’s agreement to complete and sign medical death certificates, and contact details for any alternate supervising physicians.

What is the collaborative agreement called in Ohio?

It is called a supervision agreement. Ohio provides two state templates — one for health care facilities (hospitals and ambulatory surgical facilities) and one for all other practice sites.

Who has to sign the collaborative agreement in Ohio?

The supervising physician and the PA must both sign.

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

Ohio sets no specific review or renewal requirement. Both the physician and the PA must keep a copy of the agreement in their own records for as long as it is in effect.

Is a backup physician required in Ohio?

No, a backup physician is not required. If the supervising physician chooses to designate alternate supervising physicians, though, their names, business addresses, and business telephone numbers must be written into the supervision agreement.

Board Filing Requirements

Ohio requires no board filing for the supervision agreement — it is kept on-site rather than submitted to the State Medical Board of Ohio. Both the supervising physician and the PA retain a copy in their own records and make it available on request. Because there is no filing step, there is also no waiting period and no termination notice requirement.

Source: Ohio Rev. Code § 4730.19(D)

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

No. Completed supervision agreements are maintained on-site at the practice, not filed with the State Medical Board of Ohio. The supervising physician and the PA must each retain a copy in their own records.

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

There is no filing step in Ohio, so there is no waiting period tied to one. The PA may practice once a signed supervision agreement is in place; prescribing additionally requires a valid prescriber number from the State Medical Board of Ohio.

What are the termination and notice requirements in Ohio?

Ohio sets no specific termination or notice requirement. There is no obligation to notify the Board when a supervision agreement ends, and Ohio provides no grace period if a supervising physician unexpectedly becomes unavailable.

Collaboration Compliance

The core ongoing obligation in Ohio is a quality assurance system run by the supervising physician, assessed at least twice during the PA’s first year of practice and at least once a year after that. It must include routine physician review of selected patient records and orders, feedback on the PA’s prescribing decisions, and discussion of complex cases and new medical developments. Both the physician and the PA must keep records of these activities for at least seven years.

Source: Ohio Admin. Code § 4730-1-05(C)

How many charts must a collaborating physician review in Ohio?

There is no fixed chart count, but chart review is required as part of quality assurance. The physician must routinely review selected patient record entries and medical orders, assessing the documented history and physical, whether the diagnosis and treatment plan fit that documentation, and whether the PA is practicing according to the supervisory plan or facility policies — and must give the PA feedback on prescribing decisions. Routine co-signature is not required, though during the first 500 hours of prescribing the physician documents their review by signing the PA’s patient charts.

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

Quality assurance assessment must happen at least twice during the PA’s first year of practice, then at least once per year. Ohio does not set a separate meeting cadence beyond this.

How long must collaboration records be kept in Ohio?

Quality assurance records must be kept for at least seven years. Both the supervising physician and the PA must keep them and make them available to the Board and to other health care professionals working with them.

Prescribing Rules

PAs in Ohio may prescribe and personally furnish drugs and therapeutic devices once they hold a valid prescriber number from the State Medical Board of Ohio and the supervising physician has delegated that authority. Delegated authority can never exceed the physician’s own prescriptive authority, and controlled substances additionally require federal DEA registration. Schedule II prescribing is heavily restricted, the first 500 hours of prescribing must be on-site, and a physician cannot delegate authority for any drug or device used to perform or induce an abortion.

Source: Ohio Rev. Code § 4730.41(A)

Can a PA prescribe controlled substances in Ohio?

Yes, with delegated prescriptive authority, a valid prescriber number from the State Medical Board of Ohio, and federal DEA registration. The supervising physician cannot delegate controlled-substance authority that exceeds their own.

Can a PA prescribe Schedule II drugs in Ohio?

Rarely — Ohio prohibits PAs from prescribing Schedule II drugs except at a limited list of practice sites named in statute. Those exceptions are site-based rather than drug-based; examples include a physician-owned practice organized for direct patient care where the PA has a supervision agreement with one of the physician owners, and a qualifying outpatient behavioral health practice. Check the full statutory list before assuming a site qualifies.

What schedule drugs can a PA prescribe in Ohio?

A PA may prescribe drugs and therapeutic devices within whatever authority the supervising physician delegates, which cannot exceed the physician’s own. Controlled substances require federal DEA registration, and Schedule II is off-limits outside the statutory site exceptions. A physician may not delegate authority to prescribe any drug or device that may be used to perform or induce an abortion.

Does a PA need a DEA license in Ohio?

Yes, federal DEA registration is explicitly required for a PA with delegated prescriptive authority for controlled substances. Ohio also requires a separate state credential — a valid prescriber number issued by the State Medical Board of Ohio — for prescribing generally.

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

No. Prescriptive authority is delegated by the supervising physician and is capped by that physician’s own authority, and the PA’s first 500 hours of prescribing must be under on-site supervision. After that period, individual prescriptions do not need sign-off, but the physician must still review selected orders and give the PA feedback on prescribing decisions through the quality assurance system.

Specialty & Telehealth Requirements

Ohio sets no telehealth-specific requirements for PAs, but it does have one specialty-specific rule covering emergency departments. Everywhere else, the standard collaboration, agreement, compliance, and prescribing rules apply the same way.

Source: Ohio Rev. Code § 4730.21(D)

Are there telehealth or telemedicine requirements for PAs in Ohio?

No — Ohio sets no specific telehealth or telemedicine requirement for PAs. The general availability standard still applies: outside the first 500 hours of prescribing, the supervising physician may satisfy it by being reachable through real-time electronic communication rather than being physically present.

Are there specialty-specific requirements for PAs in Ohio?

Yes, emergency departments have their own supervision rule. If the supervising physician routinely practices in the facility’s emergency department, they must provide on-site supervision whenever the PA practices there. If the physician does not routinely practice there, they may occasionally send the PA to the emergency department, but must be available to come evaluate the patient personally — and must do so if an emergency department physician asks.