Collaborative Agreement
Build an agreement

PA · pathways

Where Physician Assistants can practice independently, and what it takes

Three groups: full authority from licensure, conditional authority after a defined transition period, and supervision for the life of the practice.

Full practice authority (0)

Independent from licensure. A physician relationship is optional here.

    Conditional independence (13)

    Authority arrives after a transition period the statute defines. The conditions below are the feed's summary; each state page has the full rule and its source.

    StateConditions for independent practice
    Arizona≥8,000 hours of board-certified clinical PA practice (qualifying out-of-state hours may count toward the threshold)
    Maine≥4,000 hours of documented clinical practice (verified to the Board of Licensure in Medicine)
    Minnesota≥2,080 hours of practice within the context of a collaborative agreement, in a hospital or integrated clinical setting where PAs and physicians work together (§ 147A.02(c))
    Montana≥8,000 hours of postgraduate clinical experience as a PA (or already actively practicing with 8,000+ hours before October 1, 2023)
    North Carolina≥4,000 total hours of clinical PA experience; ≥1,000 hours in the PA's specific medical specialty; practicing in a qualifying team-based setting (physician-majority-owned practice, or a hospital/clinic with meaningful physician participation)
    North Dakota≥4,000 hours of board-approved practice (below this, a written collaborative agreement with a physician is required — N.D. Cent. Code § 43-17-02.1(6)); practicing at a licensed health care facility, a facility with a credentialing/privileging system, a physician-owned facility/practice, or a board-approved facility/practice (§ 43-17-02.1(5)) — a PA outside such a setting seeking full independent practice must instead qualify via the rural/underserved pathway below
    New Hampshire≥8,000 post-graduate clinical practice hours; Board of Medicine waiver of the collaboration-agreement requirement, obtained through the Board's waiver process — the hours threshold alone does not remove the requirement
    OklahomaExperience-based independence threshold created by H.B. 2584 (2025, eff. Nov. 1, 2025) — this research pass could not confirm the exact hours/years threshold or application criteria against primary statute text; secondary sources describing the reform explicitly decline to state the number and recommend verifying directly with the Board of Medical Licensure and Supervision
    Oregon≥2,000 hours of post-graduate PA practice experience removes the statutory minimum-monthly-collaboration-hours requirement (ORS 677.510(3)); below 2,000 hours, the written collaboration agreement must specify minimum monthly collaboration hours, both in-person and via technology
    South Dakotacertified by the National Commission on Certification of Physician Assistants (NCCPA); ≥6,000 practice hours as a PA; affidavit filed with the SD Board of Medical and Osteopathic Examiners attesting to the above (SDCL 36-4A-1.2)
    Utah≥10,000 hours of post-graduate clinical experience (below this, see agreementRequiredNote for the two lower tiers)
    Virginia≥3 years full-time clinical experience, defined as 1,800 hours/year (~5,400 hours total); attestation from one or more patient care team physicians/podiatrists who supervised that experience (attestations from multiple physicians may be aggregated)
    Washington≥4,000 hours of postgraduate clinical practice, including ≥2,000 hours in the PA's chosen specialty (a PA changing specialties must complete the first 2,000 hours in the new specialty back under supervision)

    Supervision required (39)

    No experience- or hours-based pathway. The physician agreement lasts for the life of the practice.

    Other clinicians