Pennsylvania PA Collaboration Requirements Summary

Pennsylvania requires every PA to practice under a written agreement with a primary supervising (collaborating) physician, who is responsible for the medical services the PA renders. Involvement is high in the first year and then eases: for a PA’s first 12 months out of school, and again for the first 12 months in any new specialty, the physician must countersign 100% of patient records within 10 days. Filing is unusually friendly — the written agreement is submitted to the Board but takes effect immediately on submission, so there is no waiting period, though the Board reviews a 10% sample. Day-to-day practice is otherwise flexible: Pennsylvania sets no meeting cadence, no chart review count, and no on-site requirement except for satellite offices supervised by a doctor of osteopathic medicine. This page covers Pennsylvania’s rules on collaboration, the written agreement, board filing, ongoing compliance, prescribing, and specialty and telehealth requirements.

Source: 63 P.S. § 422.13(e)

Type of Collaborative Relationship

Pennsylvania requires PAs to practice under a primary supervising physician at all times, with no route to independent practice. Involvement starts high — every chart countersigned within 10 days for the PA’s first year — and then drops to a level the physician sets in the written agreement. A PA’s authority comes from the scope of practice described in that agreement, and one physician may be responsible for up to six PAs at a time.

Source: 63 P.S. § 422.13(d)

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

A PA’s scope of practice is whatever the written agreement describes. That agreement must spell out both the PA’s scope of practice and the nature and degree of supervision the physician will provide, and it must identify the PA’s primary practice setting. Because the agreement is filed with the Board, its description is what governs.

Do PAs need a collaborating physician in Pennsylvania?

Yes. Every PA must provide medical services under a written agreement with a primary supervising physician, and that physician is responsible for the medical services the PA renders.

Can PAs practice independently in Pennsylvania?

No. Pennsylvania has no independent or autonomous practice option for PAs. Supervision eases substantially after the PA’s first year, but a primary supervising physician and a current written agreement are always required.

How many PAs can a physician collaborate with in Pennsylvania?

A physician may be responsible for or supervise no more than six PAs at any one time. A physician may apply to the Board for a waiver to exceed six for good cause.

Who can be a collaborating physician in Pennsylvania?

The primary supervising physician must hold a current, unrestricted Pennsylvania license to practice medicine and surgery. Under the State Board of Medicine’s rules, the primary supervising physician must be a medical doctor (MD). PAs who work with a doctor of osteopathic medicine (DO) fall under Pennsylvania’s separate osteopathic rules, which add the satellite-office visit requirement described below.

Are there proximity or in-person requirements in Pennsylvania?

Generally no — Pennsylvania sets no routine on-site or proximity requirement, and no availability standard. The exception is a PA working at a satellite office under a doctor of osteopathic medicine: that physician must visit the remote office at least weekly, spend enough time on-site to supervise, and personally review the records of each patient the PA saw there. A supervising physician in that situation may oversee only one satellite operation.

Collaboration Agreement Requirements

Pennsylvania’s written agreement is called exactly that — a written agreement — and the state generates it through the online registration portal rather than leaving the format open. The PA and the primary supervising physician both sign it, and it must name at least one substitute supervising physician. A current copy, along with a list of all substitutes, must be kept at the practice site and is subject to unannounced Board inspection.

Source: 49 Pa. Code § 18.142(a)

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

The written agreement must identify and be signed by the PA and the primary supervising physician, describe the PA’s scope of practice, and describe the nature and degree of supervision the physician will provide. It must also set the countersignature requirements for patient records, identify the primary practice setting where the PA will serve, and name at least one substitute supervising physician. Pennsylvania generates the agreement through the online portal when the physician is registered.

What is the collaborative agreement called in Pennsylvania?

It is called a written agreement.

Who has to sign the collaborative agreement in Pennsylvania?

The PA and the primary supervising physician must both sign.

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

Pennsylvania sets no specific review or renewal requirement. The agreement does have to stay current, though — a change to the primary practice address must be reported to the Board within 15 days.

Is a backup physician required in Pennsylvania?

Yes. The written agreement must name at least one substitute supervising physician if the PA intends to keep practicing should the primary supervising physician become permanently unable to supervise. A current list of all substitute supervising physicians the PA will work with must be kept at the practice or facility.

Board Filing Requirements

Pennsylvania requires the written agreement to be submitted to the Board, but it takes effect the moment it is submitted — there is no approval wait. The Board reviews a 10% sample of submitted agreements and sends back remedies where needed. Both a change of primary practice address and a termination of supervision must be reported within 15 days.

Source: 63 P.S. § 422.13(e)(6)

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

Yes. The written agreement must be prepared and submitted to the Board by the primary supervising physician, the PA, or a delegate of theirs. No additional documents have to be filed.

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

Yes — the agreement becomes effective upon submission to the Board. The Board reviews 10% of submitted agreements; if yours is selected, it stays in effect for two weeks after the Board reports the outcome with any remedies, and a replacement agreement must be submitted, which again takes effect on submission.

What are the termination and notice requirements in Pennsylvania?

The primary supervising physician must notify the Board of a change or termination of supervision within 15 days. If the primary supervising physician becomes permanently unable to supervise, the named substitute supervising physician assumes primary responsibility for the PA for up to 30 days while a new written agreement is filed. A change to the primary practice address carries the same 15-day deadline.

Collaboration Compliance

Pennsylvania’s main ongoing obligation is chart countersignature, not meetings or chart-review counts. The physician sets the countersignature requirement in the written agreement, except during the PA’s first 12 months post-graduation and first 12 months in a new specialty, when 100% of patient records must be countersigned within 10 days. The practice must keep records showing the physician’s patient and supervisory contact, and the Board may inspect on-site with or without notice.

Source: 63 P.S. § 422.13(d.1)

How many charts must a collaborating physician review in Pennsylvania?

There is no fixed chart review count — Pennsylvania sets no chart review requirement at all. What it requires instead is countersignature: the primary supervising physician determines how many patient records to countersign and writes that into the agreement. The exception is absolute — during the PA’s first 12 months post-graduation and the first 12 months in any new specialty, the physician must countersign 100% of records within 10 days.

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

Pennsylvania sets no specific meeting requirement. There is also no availability standard dictating how reachable the physician must be during practice hours.

How long must collaboration records be kept in Pennsylvania?

Pennsylvania sets no specific retention period. The practice must maintain records showing patient and supervisory contact by the supervising physician, along with the current written agreement and the list of substitute supervising physicians, and make them available for scheduled and unscheduled Board inspections during office hours.

Prescribing Rules

PAs in Pennsylvania may prescribe controlled substances once registered with the federal DEA, and the state adds no separate prescribing credential. Schedule II is the tightly controlled piece: a PA may prescribe up to a 72-hour dose for initial therapy, or up to a 30-day supply for ongoing therapy the supervising physician has approved. Every prescription must identify the supervising physician, and Schedule II prescriptions must state on their face whether they are for initial or ongoing therapy.

Source: 49 Pa. Code § 18.158(a)

Can a PA prescribe controlled substances in Pennsylvania?

Yes, with federal DEA registration. A PA authorized to prescribe or dispense controlled substances must register with the DEA; Pennsylvania sets no additional state requirements for prescriptive authority beyond that.

Can a PA prescribe Schedule II drugs in Pennsylvania?

Yes, but only in two narrow situations. For initial therapy, a PA may prescribe up to a 72-hour dose and must notify the supervising physician as soon as possible — no later than 24 hours after issuing the prescription. For ongoing therapy, a PA may write up to a 30-day supply only if the supervising physician approved it.

What schedule drugs can a PA prescribe in Pennsylvania?

A PA may prescribe controlled substances once registered with the DEA; Pennsylvania’s rules single out Schedule II for specific limits rather than setting a schedule-by-schedule list. Every prescription must carry the supervising physician’s name and license number, and Schedule II prescriptions must clearly state whether they are for initial or ongoing therapy.

Does a PA need a DEA license in Pennsylvania?

Yes, a PA authorized to prescribe or dispense controlled substances must register with the federal DEA. Pennsylvania does not add a separate state controlled-substances registration.

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

No. Prescribing happens under the written agreement, and the supervising physician remains responsible for the PA’s medical services. Routine prescriptions do not need individual sign-off, but Schedule II ongoing therapy requires the physician’s prior approval, initial Schedule II therapy requires notifying the physician within 24 hours, and during the PA’s first 12 months — and first 12 months in a new specialty — every patient record must be countersigned within 10 days.

Specialty & Telehealth Requirements

Pennsylvania 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 whether care is delivered in person or remotely.

Source: 49 Pa. Code Ch. 18 (general PA requirements; Pennsylvania’s PA rules contain no specialty- or telehealth-specific provision)

Are there telehealth or telemedicine requirements for PAs in Pennsylvania?

No — Pennsylvania sets no specific telehealth or telemedicine requirement for PAs. The state’s general collaboration rules apply, and because there is no routine on-site or availability requirement, no telehealth exemption is needed.

Are there specialty-specific requirements for PAs in Pennsylvania?

No — Pennsylvania sets no specialty-specific requirement for PAs. Changing specialties does carry a supervision consequence, though: the first 12 months practicing in a new specialty restart the requirement that the physician countersign 100% of patient records within 10 days.