PA · Ohio
Collaborative Practice Agreement for Physician Assistants in Ohio
Yes, a written physician agreement is required. Ohio calls it a Supervision Agreement.
No independent-practice pathway exists for PAs in Ohio at any tenure. A pending bill (H.B. 963) would remove the geographic-proximity requirement and other administrative burdens, but per the sponsoring association's own tracker, it 'remains pending' with no hearing yet — not 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
after the first 500 hours of delegated prescriptive authority: Available remotely (no on-site requirement)
Ohio Rev. Code §4730.21: the supervising physician must be 'continuously available for direct communication,' either physically present or 'readily available through telecommunication' — no mileage/radius standard is codified.
first 500 hours of exercising delegated prescriptive authority: On-site presence required
Ohio Rev. Code §4730.44 (confirmed verbatim in a follow-up pass; also via OAC 4730-1-06): 'During the first five hundred hours of a physician assistant's exercise of physician-delegated prescriptive authority, the physician assistant shall exercise that authority only under the on-site supervision of a supervising physician.' Only after this threshold does the general telecommunication-availability standard apply. EXEMPTION: §4730.44 also exempts PAs with ≥1,000 hours of prior prescriptive-authority experience from another state, or from military/VA/U.S. Public Health Service practice, from this 500-hour on-site startup period entirely.
Supervision ratio
Up to 5 at a time
A physician may not supervise more than 5 PAs at any one time (Ohio Rev. Code §4730.21) — consistent across multiple independent secondary sources but not independently re-confirmed against raw statute text (codes.ohio.gov was unreachable throughout this research pass). The cap is on concurrent active supervision, not total signed supervision agreements.
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
OARRS consultation required before prescribing opioids/benzodiazepines (narrow exceptions for hospice/terminal, institutional administration, ≤7-day scripts, and cancer treatment absent red flags), then at least every 90 days during ongoing opioid/benzodiazepine treatment, or at least annually for other reportable drugs prescribed 90+ days (OAC 4730-2-10).
Written agreement
Required
Unconditional — Ohio's term is a 'supervision agreement' (Ohio Rev. Code §4730.19), which may not cover more than one supervising physician per PA-side agreement, though one physician may hold agreements with multiple PAs up to the ratio cap.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — Ohio has NO corporate-practice-of-medicine doctrine — the State Medical Board formally declared (3/15/2012) that Ohio law does not prohibit a physician from rendering services as a corporate employee, grounded in Ohio Rev. Code §4731.226 (authorized business-entity forms: corporations, LLCs, partnerships, professional associations). Physicians may form multidisciplinary entities combining with other licensed professionals under §4731.226(C), which expressly overrides professional codes of ethics that would otherwise bar combination practice.
Legal sources for these rules (9)
- Ohio Rev. Code §4730.19 — Supervision agreement
- Ohio Rev. Code §4730.21 — Proximity/telecommunication standard, 5-PA ratio cap
- Ohio Rev. Code §4730.41, §4730.411 — PA prescriptive authority, Schedule II restrictions
- Ohio Rev. Code §4730.44 — 500-hour on-site prescriptive-authority startup period
- OAC 4730-1-06 — 500-hour on-site period implementation (via Cornell LII mirror, read directly)secondary
- OAC 4730-2-04 — PA supervision/prescribing competence standards (via Cornell LII mirror, read directly)secondary
- OAC 4730-2-10 — OARRS consultation requirements (via Cornell LII mirror, read directly)secondary
- Ohio Rev. Code §4731.226 — Authorized business-entity forms (CPOM)
- H.B. 963 (current General Assembly) — pending PA-practice modernization, not enacted
What a collaborating physician costs here
Typical monthly cost in Ohio
$550 – $850
Estimate for one Physician Assistant. This state's rules add a restrictive-tier premium.
About Ohio's rules
Ohio recently relaxed CRNA supervision from 'immediate presence' to facility-wide 'collaboration' (H.B. 52, eff. 6/8/2026, now current law), and will loosen RN laser-delegation rules similarly (H.B. 377, eff. 8/25/2026 — NOT yet law as of this file's date). No independent-practice pathway exists for NP/PMHNP/PA despite active pending reform bills (a 2,000-hour NP threshold, PA proximity removal) — none enacted. Ohio has no corporate-practice-of-medicine doctrine (State Medical Board, 2012). Non-nurse midwifery has no current licensure pathway.
Other clinicians in Ohio: see the state overview.