PA · Colorado

Collaborative Practice Agreement for Physician Assistants in Colorado

Yes, a written physician agreement is required. Colorado calls it a Collaborative Agreement.

Practice authoritySupervision required
Written agreementAgreement required
What Colorado calls itCollaborative Agreement
Governing boardColorado Medical Board and the Colorado State Board of Pharmacy
Agreement familySupervising Physician + Collaborative Practice
Research date2026-08-20 · clauses 2026-09-03

SB23-083 (2023, eff. 8/7/2023) replaced physician 'supervision' with a 'collaborative agreement' — still always required, but PAs with ≥5,000 career practice hours (or ≥3,000 in a new practice area) collaborate rather than being supervised, with scope tied to the PA's own education/experience/competency rather than the collaborating physician's. No hours-based path to zero agreement exists. PAs in Level I/II trauma-center EDs remain supervision-only indefinitely, regardless of hours.

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

No proximity requirement

Fetched 3 CCR 713-1.15 Section C in full: no PA-reachability/telecommunication standard exists in the current rule — the pre-2023 'readily available by telephone, radio, pager, or other telecommunication device' language (3 CCR 713-7.1(D)(8)(b)) was not carried forward into the recodification. The only proximity-adjacent text left is § C(3)(a)'s requirement that the collaborating physician maintain 'a regular and reliable physical presence in Colorado' (telehealth-only practice doesn't satisfy it) — but that governs the physician's own general CO practice, not reachability to this specific PA, so it doesn't amount to a proximity rule in this field's sense.

Supervision ratio

Not codified — no cap on file

Chart review

Not codified — left to the agreement

Meeting cadence

Every 6 months, in person or via telehealth

§ 12-240-114.5(2)(b)(I)(C) requires formal performance evaluations at 6 months and again at 12 months, with 'additional evaluation thereafter' left unspecified in frequency — coded BIANNUAL for the confirmed first-year cadence, though the ongoing frequency after year one isn't fixed by statute. Acceptable evaluation methods include 'chart review with identification of charts reviewed' (3 CCR 713-1.15(C)(3)(b)(4)) — an available method, not a mandated percentage/quota (see the empty `chartReview` list above). The first 160 practice hours for a newly practicing or practice-area-changing PA must be completed in person or via technology (§ 12-240-114.5(2)(b)(I)(A)).

Prescriptive authority

Covered by the practice agreement · controlled substances permitted

No Colorado-specific schedule restriction (e.g., a Texas-style Schedule-II hospital/hospice limit) was located for PAs in this pass — this doesn't confirm one doesn't exist, only that this research pass didn't verify the full current text of § 12-240-107(6)/-113 closely enough to rule it out. Flag as unconfirmed if load-bearing.

Written agreement

Required

Unconditional — some written agreement (supervisory or collaborative, depending on the PA's practice hours) is always required for the life of a PA's practice; only the CONTENT of the relationship branches, not whether one must exist. See `supervision` below and the hours thresholds in the notes above.

Practice ownership (corporate practice of medicine)

Licensee-only ownership required — Professional service corporation, LLC, or registered LLP organized solely for the practice of medicine (C.R.S. § 12-240-138) — shareholders must be Colorado-licensed physicians, with a named exception letting one or more PAs hold shares as long as physician-shareholders keep majority ownership (§ 12-240-138(1)(d)(I)). An heir may hold non-voting shares for up to 2 years after a physician-shareholder's death regardless of licensure (§ 12-240-138(1)(d)(II)).

A 2026 bill (HB26-1249) would have let PAs (and estheticians/RNs/APRNs) become shareholders in corporations organized solely to provide medical-aesthetic services — postponed indefinitely by a 13-0 House Health & Human Services Committee vote on 3/25/2026, so current ownership law is unchanged.

Legal sources for these rules (7)
The document: Collaborative Agreement
What a Colorado Collaborative Agreement must contain, who governs it and who signs: read the Collaborative Agreement page on practiceagreement.com.

What a collaborating physician costs here

Typical monthly cost in Colorado

$500$700

Estimate for one Physician Assistant. Standard-tier state.

About Colorado's rules

Colorado is a full-practice-authority state for all five APRN roles (NP/PMHNP/CRNA/CNM/CNS) — no physician agreement is ever required to practice. APRNs instead face a 750-hour prescribing mentorship (not necessarily physician-led) before 'full' (vs. 'provisional') prescriptive authority — a credentialing gate, not a supervision relationship. PAs moved from physician 'supervision' to an hours-gated 'collaborative agreement' under SB23-083 (2023) — not 'HB23-1214,' which could not be located and appears to be a misattribution. Colorado licenses estheticians; it has not deregulated the profession.

Other clinicians in Colorado: see the state overview.