Practice Agreement · PA
California Practice Agreement for Physician Assistants
Required. The Practice Agreement is the written instrument California 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.
No independent-practice pathway currently exists for PAs. AB 2028 (2019-2020) replaced the old 'supervision agreement' model with a 'practice agreement' and loosened administrative requirements, but physician oversight remains legally mandatory. AB 1501 (2025) directs the PA Board to study independent-practice models used in other states — not yet enacted.
What a California Practice Agreement must contain
Governed by the Medical Board of California and the California State Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Physician Assistant ("PA") shall practice pursuant to a written practice agreement with the Physician, as required by Business and Professions Code §§ 3502 and 3502.3, and shall be licensed and in good standing with the California Physician Assistant Board. The practice agreement shall identify the medical services the Physician Assistant is authorized to perform, the policies and procedures for adequate supervision — including the Physician's availability for communication, consultation, and referral — and the method by which the Physician Assistant's competency will be continuously evaluated. Where the Physician Assistant practices within an organized health care system, this practice agreement may be approved on behalf of the system's physicians by a single authorized physician, consistent with § 3502.
A supervising physician may not have practice agreements in effect with more than eight (8) Physician Assistants at any one time, as provided under California law. If the Physician Assistant has authority to furnish or order drugs or devices, the practice agreement shall set forth that authority consistent with § 3502.1. The Parties shall retain a current signed copy of the practice agreement and shall produce it to the California Physician Assistant Board upon request.
- The Practice Agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- Cal. Bus. & Prof. Code § 4052statute
Authorizes a pharmacist, under a collaborative practice agreement with a health care provider with prescriptive authority (or under a prescriber's written order/authorization consistent with entity policy), to initiate, adjust, or discontinue drug therapy for a patient, subject to notification and other conditions.
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
Available remotely (no on-site requirement)
Bus. & Prof. Code §3501: physical presence of the supervising physician is explicitly NOT required; the physician must be reachable 'by telephone or other electronic communication method' while the PA is examining a patient. No mileage/radius standard is codified.
Supervision ratio
Up to 8 at a time
Bus. & Prof. Code §3516(b), as amended by AB 1501 (2025, eff. 1/1/2026): 'a physician and surgeon shall not supervise more than eight physician assistants at any one time' — a universal increase from the prior 4-PA cap (a narrower 2023 exception, AB 1070, had allowed 8 only for limited in-home/wellness-visit PAs; AB 1501 made 8:1 universal). Exact statutory wording not independently re-verified against chaptered text — sourced via an AI-summarized bill-text fetch plus consistent law-firm corroboration.
Chart review
0% of charts · As needed
Coded 0%/as-needed to distinguish an affirmative statutory exemption from silence: Bus. & Prof. Code §3502(c) states physicians are NOT required to review/countersign PA records 'unless required by the practice agreement.' The Medical Board may separately impose chart-review conditions on an individual physician's probation, but there's no general statutory percentage.
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Bus. & Prof. Code §3502.1 (Schedule II/III mechanics) was not independently fetched verbatim — sourced via Justia/FindLaw secondary summaries, moderately confirmed. The CURES 6-month recheck figure is confirmed via direct statute fetch; a conflicting '4 months' figure appears in some secondary sources and should be treated as superseded/incorrect.
Written agreement
Required
Unconditional — Bus. & Prof. Code §3501 defines supervision as the physician 'oversee[ing] the activities of, and accept[ing] responsibility for' the PA's medical services via a 'practice agreement' (renamed from 'supervision agreement' by AB 2028). Always required; no PA tier operates without one.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — General CPOM baseline: Bus. & Prof. Code §2400 bars corporations from holding 'professional rights, privileges, or powers.' NOTABLE EXCEPTION, CONFIRMED via direct fetch: Corp. Code §13401.5(i) recognizes a 'Physician Assistants Corporation' structure under which licensed PAs hold the MAJORITY (≥51%) of shares, with physicians, RNs, acupuncturists, naturopathic doctors, and licensed midwives eligible only as minority shareholders — the reverse of the usual assumption that CA requires physician ownership of everything. Entity ownership is legally separate from clinical independence, though: even a PA-majority-owned corporation must still operate its clinical PA services under a practice agreement with a supervising physician.
Corp. Code §13401.5(i)'s subsection letter and the PA ≥51%/minority-shareholder-list structure are confirmed via a dedicated follow-up fetch, superseding the original secondary-sourced hedge.
Legal sources for these rules (11)
- Bus. & Prof. Code §3501 — Physician assistant definitions ('practice agreement,' supervision standard)
- Bus. & Prof. Code §3502 — PA scope, chart-review exemption
- Bus. & Prof. Code §3502.1 — Controlled-substance furnishing (secondary-sourced, not independently fetched verbatim)
- Bus. & Prof. Code §3516(b) — Supervision ratio (8 PAs), as amended by AB 1501 (2025)
- Bus. & Prof. Code §2400 — General corporate-practice-of-medicine bar
- Corp. Code §13401.5(i) — Physician Assistants Corporation ownership, confirmed verbatim
- Health & Safety Code §11165.4 — CURES consultation mandate
- AB 2028 (2019-2020) — 'practice agreement' reform
- AB 1070 (2023) — narrow 8-PA exception for limited in-home/wellness-visit PAs, superseded by AB 1501's universal 8:1 cap
- AB 1501 (2025, Ch. 194) — universal 8-PA ratio, PA Board sunset extension to 2030, directs independent-practice study
- CA AG — Carbon Health CPOM settlement press release (June 2026)
About California's rules
California's NPs reach genuine full independence (AB 890/SB 1451, ~6 years total) and CNMs need zero physician involvement for definitionally 'low-risk' pregnancy care — no hours threshold. NPs/PAs may also majority-own their own practice corporations (Corp. Code §13401.5), cutting against the assumption that CA's strict, actively-enforced CPOM regime (2026 AG settlements against Carbon Health, Aspen Dental) blocks all non-physician ownership. CRNA is order-based, not supervision-based. Esthetician laser use is a flat criminal misdemeanor — no delegation pathway exists.
Other clinicians in California: see the state overview.