Selected SLC Research


Policy Analysis | June 14, 2016

Scope of Practice – Physician Assistants (PAs)

Roger Moore

Scope of practice describes the procedures, actions and processes that a healthcare practitioner in a given field is permitted to undertake according to the law. Scope of practice policies and regulations, which are applicable to professionals across the field of medicine, vary substantially from state to state and, in some instances, continue to spark passionate debates about the proper extent to which medical professionals should be permitted to exercise certain responsibilities.

Physician Assistants, or PAs, are nationally certified and state-licensed medical professionals who work with physicians and other providers to treat patients. Among other things, PAs can take patients’ medical history, conduct physical exams, diagnose and treat illnesses, order and interpret tests, develop treatment plans, counsel on preventive care, assist in surgery, write prescriptions, and make rounds in hospitals and nursing homes. However, specifically designated duties depend on a number of factors, including work setting, level of experience, specialty and, lastly, state laws.

A list of scope of practice regulations currently in place among SLC states, as well as a set of maps outlining various scope of practice policies throughout the United States, follows.*

Scope of Practice – Physician Assistants (PAs)

SLC States Full prescriptive authority Scope of practice determined on site Adaptable supervision requirements Co-sign requirements determined at practice Maximum number of PAs a physician can supervise at one time
Alabama Yes No No No 4
Arkansas No Yes No Yes N/A
Florida No No No Yes 4
Georgia No No Yes No 4
Kentucky No No No No 2
Louisiana Yes Yes Yes Yes 2
Mississippi Yes No No No 2
Missouri No Yes No No 3
North Carolina Yes Yes No Yes N/A
Oklahoma No No Yes No 2
South Carolina Yes No No No 4
Tennessee Yes Yes No No N/A
Texas Yes Yes Yes Yes 7
Virginia Yes No No No 6
West Virginia No No No No 3

Glossary

Full prescriptive authority: Refers to whether or not PA prescriptive authority is determined at the practice level by the supervising physician.

Scope of practice determined on site: Refers to whether or not the supervising physician and PA jointly establish a written agreement outlining the PA’s scope of practice.

Adaptable supervision requirements: Refers to whether or not the circumstance of each practice determine the exact means by which responsible supervision is accomplished. If supervision requirements are not adaptable, state law determines the exact means by which responsible supervision is accomplished.

Co-sign requirements determined at practice: Refers to whether or not co-signature requirements for PAs are determined at the practice level by the supervising physician.

Maximum number of PAs a physician can supervise at one time: Refers to the limit on the number of PAs a physician can supervise at one time. If no numerical limit is listed, law does not include a specific numerical limit on the number of PAs that one physician may supervise.

Full prescriptive authority

Scope of practice determined on site

Adaptable supervision requirements

Co-sign requirements determined at practice

Maximum number of PAs a physician can supervise at one time

* The information is provided by the Henry J. Kaiser Family Foundation.