PA · District of Columbia
Collaborative Practice Agreement for Physician Assistants in District of Columbia
Yes, a written physician agreement is required. District of Columbia calls it a Delegation Agreement.
DC was not identified among the states that have adopted an experience-based autonomous-practice pathway for PAs (as of this pass, unlike e.g. Virginia's 2026 reform or North Dakota's) — a PA in DC needs an active Delegation Agreement with a supervising physician for as long as they practice.
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)
17 DCMR § 4914 requires the PA be under physician supervision at all times while practicing, but no on-site or mile/minute radius standard was confirmed in this pass — treat the specific proximity mechanics as an open item pending direct confirmation of the full regulation text.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Quarterly
The PA and a supervising physician listed on the Delegation Agreement must complete a documented 'Practice Advisory Review' quarterly, kept in the PA's personnel file at the practice site (DC Health Delegation Agreement form; D.C. Code § 3-1204 framework).
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
The Delegation Agreement must address the PA's delegated prescriptive authority; controlled-substance prescribing requires the supervising physician to delegate that authority and the PA to hold its own DC controlled-substance registration plus DEA registration. Specific schedule-level restrictions were not confirmed in this pass — do not assume unrestricted Schedule II authority without verifying the current Delegation Agreement form/17 DCMR text.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Corporation or PLLC under D.C. Code § 29-508 — secondary-sourced guidance describes 100% licensed-physician ownership, all directors/officers physician-licensed, and shares transferable only to physicians or the corporation itself. No DC statute was found enumerating PAs as an eligible independent owner of such an entity — treat PA independent practice-entity ownership as an open item.
This ownership question is distinct from the Delegation Agreement below, which governs clinical oversight of the PA, not who may own the entity the PA practices through.
Legal sources for these rules (5)
- D.C. Code § 3-1204 — Board of Medicine authority over PA delegation agreements
- 17 DCMR § 4914 — Supervision (Physician Assistants)
- 17 DCMR § 4911 — Scope of Practice (Physician Assistants)
- DC Health — Physician Assistant Delegation Agreement form
- D.C. Code § 29-508 — Professional corporation ownership requirements (secondary-sourced summary)secondary
What a collaborating physician costs here
Typical monthly cost in District of Columbia
$500 – $700
Estimate for one Physician Assistant. This state's proximity rules add a small premium.
About District of Columbia's rules
The Health Occupations Revision Amendment Act of 2024 repealed D.C. Code § 3-1206.03, eliminating the collaboration mandate for all APRN categories (NP/PMHNP/CRNA/CNM/CNS) — DC is now a full-practice-authority jurisdiction for APRNs. PAs are NOT covered by that reform and still require a Board of Medicine Delegation Agreement regardless of experience; no autonomous-PA pathway was found in DC as of this pass.
Other clinicians in District of Columbia: see the state overview.