PA · California
Collaborative Practice Agreement for Physician Assistants in California
Yes, a written physician agreement is required. California calls it a Practice Agreement.
No independent-practice pathway currently exists for PAs. AB 2028 (2019-2020) replaced the old 'supervision agreement' model with a 'practice agreement' and loosened administrative requirements, but physician oversight remains legally mandatory. AB 1501 (2025) directs the PA Board to study independent-practice models used in other states — not yet enacted.
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Available remotely (no on-site requirement)
Bus. & Prof. Code §3501: physical presence of the supervising physician is explicitly NOT required; the physician must be reachable 'by telephone or other electronic communication method' while the PA is examining a patient. No mileage/radius standard is codified.
Supervision ratio
Up to 8 at a time
Bus. & Prof. Code §3516(b), as amended by AB 1501 (2025, eff. 1/1/2026): 'a physician and surgeon shall not supervise more than eight physician assistants at any one time' — a universal increase from the prior 4-PA cap (a narrower 2023 exception, AB 1070, had allowed 8 only for limited in-home/wellness-visit PAs; AB 1501 made 8:1 universal). Exact statutory wording not independently re-verified against chaptered text — sourced via an AI-summarized bill-text fetch plus consistent law-firm corroboration.
Chart review
0% of charts · As needed
Coded 0%/as-needed to distinguish an affirmative statutory exemption from silence: Bus. & Prof. Code §3502(c) states physicians are NOT required to review/countersign PA records 'unless required by the practice agreement.' The Medical Board may separately impose chart-review conditions on an individual physician's probation, but there's no general statutory percentage.
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Bus. & Prof. Code §3502.1 (Schedule II/III mechanics) was not independently fetched verbatim — sourced via Justia/FindLaw secondary summaries, moderately confirmed. The CURES 6-month recheck figure is confirmed via direct statute fetch; a conflicting '4 months' figure appears in some secondary sources and should be treated as superseded/incorrect.
Written agreement
Required
Unconditional — Bus. & Prof. Code §3501 defines supervision as the physician 'oversee[ing] the activities of, and accept[ing] responsibility for' the PA's medical services via a 'practice agreement' (renamed from 'supervision agreement' by AB 2028). Always required; no PA tier operates without one.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — General CPOM baseline: Bus. & Prof. Code §2400 bars corporations from holding 'professional rights, privileges, or powers.' NOTABLE EXCEPTION, CONFIRMED via direct fetch: Corp. Code §13401.5(i) recognizes a 'Physician Assistants Corporation' structure under which licensed PAs hold the MAJORITY (≥51%) of shares, with physicians, RNs, acupuncturists, naturopathic doctors, and licensed midwives eligible only as minority shareholders — the reverse of the usual assumption that CA requires physician ownership of everything. Entity ownership is legally separate from clinical independence, though: even a PA-majority-owned corporation must still operate its clinical PA services under a practice agreement with a supervising physician.
Corp. Code §13401.5(i)'s subsection letter and the PA ≥51%/minority-shareholder-list structure are confirmed via a dedicated follow-up fetch, superseding the original secondary-sourced hedge.
Legal sources for these rules (11)
- Bus. & Prof. Code §3501 — Physician assistant definitions ('practice agreement,' supervision standard)
- Bus. & Prof. Code §3502 — PA scope, chart-review exemption
- Bus. & Prof. Code §3502.1 — Controlled-substance furnishing (secondary-sourced, not independently fetched verbatim)
- Bus. & Prof. Code §3516(b) — Supervision ratio (8 PAs), as amended by AB 1501 (2025)
- Bus. & Prof. Code §2400 — General corporate-practice-of-medicine bar
- Corp. Code §13401.5(i) — Physician Assistants Corporation ownership, confirmed verbatim
- Health & Safety Code §11165.4 — CURES consultation mandate
- AB 2028 (2019-2020) — 'practice agreement' reform
- AB 1070 (2023) — narrow 8-PA exception for limited in-home/wellness-visit PAs, superseded by AB 1501's universal 8:1 cap
- AB 1501 (2025, Ch. 194) — universal 8-PA ratio, PA Board sunset extension to 2030, directs independent-practice study
- CA AG — Carbon Health CPOM settlement press release (June 2026)
What a collaborating physician costs here
Typical monthly cost in California
$500 – $600
Estimate for one Physician Assistant. This state's rules add a restrictive-tier premium.
About California's rules
California's NPs reach genuine full independence (AB 890/SB 1451, ~6 years total) and CNMs need zero physician involvement for definitionally 'low-risk' pregnancy care — no hours threshold. NPs/PAs may also majority-own their own practice corporations (Corp. Code §13401.5), cutting against the assumption that CA's strict, actively-enforced CPOM regime (2026 AG settlements against Carbon Health, Aspen Dental) blocks all non-physician ownership. CRNA is order-based, not supervision-based. Esthetician laser use is a flat criminal misdemeanor — no delegation pathway exists.
Other clinicians in California: see the state overview.