PA · Indiana

Collaborative Practice Agreement for Physician Assistants in Indiana

Yes, a written physician agreement is required. Indiana calls it a Written Supervisory Agreement.

Practice authoritySupervision required
Written agreementAgreement required
What Indiana calls itWritten Supervisory Agreement
Governing boardMedical Licensing Board of Indiana and the Indiana Board of Pharmacy
Agreement familySupervising Physician
Research date2026-08-21 · clauses 2026-09-03

IC 25-27.5-5-2 requires a PA to 'engage in a dependent practice with a collaborating physician' — no hours-, experience-, or tenure-based pathway to independent practice exists at any point in a PA's career. Indiana relabelled the relationship from 'supervision' to 'collaboration' (chapter headings in some code mirrors still read 'Supervision of Physician Assistants' while the section text reads 'collaborating physician'), but the substantive controls — a ratio cap, chart review, and board filing — all survived that relabelling.

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

IC 25-27.5-6-1(a): collaboration 'must be continuous but does not require the physical presence of the collaborating physician at the time and the place that the services are rendered.' No mileage/radius or reachability standard is codified — 'continuous' is a relationship standard, not a distance one. Contrast the CRNA entry, where Indiana does impose immediate physical presence.

Supervision ratio

Up to 4 at a time

IC 25-27.5-6-2: a physician 'may enter into a collaborative agreement with more than four (4) physician assistants but may not collaborate with more than four (4) physician assistants at the same time.' No exception was found for hospital-based or medically-underserved practice — unlike Texas's § 157.0512(d) carve-outs. This is a PA-only cap: no corresponding APRN cap was located in IC 25-23-1 or 848 IAC, so it is NOT a combined roster like Texas's 7-FTE cap.

Chart review

first year in which the PA has authority to prescribe: 10% of charts · As needed (not later than 10 business days after the patient encounter)

IC 25-27.5-6-1(c)(1) requires review of at least ten percent (10%) of the patient's records for any prescription prescribed or administered by the PA during that first year. Frequency is coded AS_NEEDED because the statute fixes a DEADLINE (10 business days per encounter, § 6-1(b)-(c)) rather than a repeating review cycle. IMPORTANT: the often-quoted Indiana figures of 25% (first year of practice) and 50% (Schedule II records) are the SUPERSEDED 2015 text of this same subsection and should not be used.

each subsequent year of practice: Percentage set by agreement · As needed (not later than 10 business days after the patient encounter)

No percentage is codified for years after the first — IC 25-27.5-6-1(c)(2) leaves 'the percentage of charts that the collaborating physician or physician designee determines to be reasonable for the particular practice setting and level of experience' to the agreement. Read this entry as 'a review obligation exists but its size is contractual,' NOT as 'zero charts.' The 10-business-day encounter-review deadline of § 6-1(b) continues to apply; a separate 14-business-day deadline applies to in-home wellness visits with no treatment or prescribing (§ 6-1(d)).

Meeting cadence

Annually, in person or via telehealth

No periodic in-person or scheduled meeting is codified. The only fixed recurring obligation located is documentary: IC 25-27.5-6-4(a)(5) requires the written collaborative agreement to be 'updated annually' and made available to the board on request. IC 25-27.5-6-3 separately obliges the physician/PA team to establish and maintain a performance-evaluation process but sets no cadence for it.

Prescriptive authority

Covered by the practice agreement · controlled substances permitted

No separate prescriptive-authority document exists — prescribing rides on the same collaborative agreement, whose 'protocol for drug prescribing' is one of the agreement's required contents (IC 25-27.5-5-2). The PA must hold BOTH an Indiana Controlled Substance Registration and a federal DEA registration (IC 35-48-3-3; Indiana PLA CSR guidance) — Indiana retained the state-level registration Texas repealed in 2015.

Written agreement

Required

Unconditional, and unusually formalized: the collaborating physician must register the intent to collaborate with the board, submit a list of the locations where the pair may practice, and maintain a written agreement that is signed by both, updated annually, and produced to the board on request (IC 25-27.5-6-4). The agreement itself is submitted to the board by the collaborating physician, and any amendment must be resubmitted (IC 25-27.5-5-2).

Practice ownership (corporate practice of medicine)

Licensee-only ownership required — Physician-owned professional corporation or equivalent. PAs are NOT among the licensed professions listed in IC 25-22.5-1-2(a)(22) whose members may own a health care organization outside the Medical Practice Act — that list reaches physicians, hospitals, HMOs, dentists, RNs/LPNs, certified nurse midwives, optometrists, podiatrists, chiropractors, physical therapists, and psychologists, but not PAs. Indiana therefore does NOT give PAs the express statutory joint-ownership pathway Texas does (Tex. Bus. Orgs. Code § 301.012).

OPEN QUESTION, deliberately not answered here: a PA is a 'health care professional' for the Professional Corporation Act (IC 23-1.5-1-8 defines the term by reference to the boards listed in IC 25-0.5-11, which includes the physician assistant committee at § 11-17), and IC 23-1.5-2-3(a)(4) lets 'one (1) or more health care professionals' form a PC. But IC 23-1.5-3-1(a)(1) issues shares only to individuals authorized to render 'a professional service permitted by the articles of incorporation,' which cuts against a PA co-owning a PC whose articles cover the practice of medicine. No board rule or opinion resolving this was located. Do not rely on either answer without counsel.

Legal sources for these rules (9)
The document: Written Supervisory Agreement
What a Indiana Written Supervisory Agreement must contain, who governs it and who signs: read the Written Supervisory Agreement page on practiceagreement.com.

What a collaborating physician costs here

Typical monthly cost in Indiana

$600$900

Estimate for one Physician Assistant. This state's rules add a restrictive-tier premium.

About Indiana's rules

Indiana requires a career-long collaborative practice agreement for every APRN role except CRNAs (IC 25-23-1-19.4(c)); APRN prescribers additionally face a codified 5%-of-charts random-sampling review (848 IAC 5-1-1). CRNAs instead face a stricter rule — physician direction and immediate presence (IC 25-23-1-30). Widely repeated reports that Indiana enacted full practice authority in 2026 are unsupported: HB 1116, HB 1129 and SB 60 all failed. Indiana's corporate-practice doctrine is comparatively permissive.

Other clinicians in Indiana: see the state overview.