Collaborative Practice Agreement · PA
Colorado Collaborative Agreement for Physician Assistants
Required. The Collaborative Agreement is the written instrument Colorado law names for a Physician Assistant working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
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 a Colorado Collaborative Agreement must contain
Governed by the Colorado Medical Board and the Colorado State Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
If the Physician Assistant ("PA") has fewer than five thousand (5,000) total practice hours, or fewer than three thousand (3,000) hours in a new practice area, or practices in a Level I or Level II trauma center emergency department, the Physician Assistant shall practice under the supervision of the Physician. Otherwise, the Physician Assistant shall practice under a Collaborative Agreement with the Physician, as provided under C.R.S. § 12-240-114.5, following the elimination of the general physician-supervision requirement by SB23-083.
The Collaborative Agreement (or supervisory arrangement, if still applicable) shall state the Physician Assistant's name and license number, the primary practice location, the signatures of the Physician Assistant and the Physician, a description of the collaboration process, and the performance-evaluation process. Colorado law does not fix a numerical limit on the number of Physician Assistants with whom a physician may enter into a Collaborative Agreement. The agreement shall be kept at the Physician Assistant's primary practice location and produced to the Colorado Medical Board upon request; it need not be filed with the Board in advance.
- The Collaborative Agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- Colo. Rev. Stat. §§ 12-280-601 to 12-280-604 and 3 CCR 719-1, Rule 17 (Collaborative Pharmacy Practice)board guidance
Colorado State Board of Pharmacy's own page describing the collaborative pharmacy practice agreement framework and statewide drug therapy protocols authorized under Title 12, Article 280, Part 6 of the Colorado Revised Statutes and Pharmacy Rule 17.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
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)
- C.R.S. § 12-240-114.5 — Physician Assistants, Collaboration Requirementssecondary
- C.R.S. § 12-240-113 — Physician Assistant License, Qualificationssecondary
- C.R.S. § 12-240-138 — Professional Service Corporations/LLCs/LLPs for the Practice of Medicine
- 3 CCR 713-1.15 — Colorado Medical Board, Rules and Regulations Regarding the Licensure of and Practice by Physician Assistants (current, post-SB23-083 recodification)secondary
- 3 CCR 713-7.1 — superseded PA supervision rule, cited only for its pre-2023 8-PA ratio cap and telecommunication-availability standard (see notes above)secondary
- SB23-083 (2023) — Physician Assistant Collaboration Requirements, signed 4/26/2023, eff. 8/7/2023
- HB26-1249 (2026) — Medical-Aesthetics Corporation Ownership, postponed indefinitely 3/25/2026
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.