Practice Agreement · PA
Physician Assistant Practice Agreement in Kentucky
Kentucky law does not require a Physician Assistant to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.
PAs may not practice medicine independently in Kentucky at any level of experience — no autonomous/team-based-practice reform comparable to NC's or VA's has been enacted here. A supervising physician must be Board-approved for each PA supervised (KRS 311.854), and remains responsible for the PA's actions for as long as the relationship continues.
What a Physician Assistant practice agreement covers in Kentucky
Governed by the Kentucky Board of Medical Licensure and the Kentucky Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Physician Assistant ("PA") shall practice under the supervision of the Physician, who shall apply for and receive Kentucky Board of Medical Licensure approval to supervise the Physician Assistant specifically, as required by KRS 311.840 et seq. A supervising physician may not be approved to supervise more than four (4) Physician Assistants at one time, as provided under KRS 311.854.
Effective July 15, 2026, under Senate Bill 116 (2026), the Physician Assistant's prescriptive authority may extend to Schedule II controlled substances if the supervising physician's approval and the Physician Assistant's delegation agreement so provide.
- The agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- 201 KAR 2:220regulation
Establishes minimum requirements for the development and maintenance of collaborative care agreements between a pharmacist and a practitioner.
- KRS 315.010(4)statute
Chapter 315 definitions, including "collaborative care agreement."
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)
KRS 311.856 permits a PA to practice at a location separate from the supervising physician if the physician remains continuously available by telecommunication; no mile/minute radius is codified. 'Adequate, active, and continuous supervision' is the statutory standard, undefined further by rule.
Supervision ratio
Up to 4 at a time
A physician may not supervise more than 4 PAs at any one time (KRS 311.854), each requiring separate Board approval. Tighter than NC's (uncapped) and VA's (6) PA ratios.
Chart review
Percentage set by agreement · As needed · countersignature required
KRS 311.856 requires the supervising physician to review and countersign 'a sufficient number of overall medical notes' to ensure quality of care, but leaves both the percentage and the review cadence to be 'determined by the supervising physician, practice, or institution' — no statutory number or frequency exists to cite; AS_NEEDED reflects that the statute itself sets no fixed cadence, not that review is optional.
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Schedule II authority (added by S.B. 116) and Schedules III–V require ≥1 year of licensed PA practice, a Board application signed by the supervising physician, Board approval, individual DEA registration, and KASPER (PDMP) enrollment — all on top of, and delegated within, the general supervision agreement (KRS 311.858).
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Service Corporation (KRS Ch. 274) — ownership is restricted to persons licensed to render the corporation's specific professional service. A PA is not licensed to independently render medical services (KRS 311.858 requires practice as an agent of a supervising physician), so an independent PA-owned medical-practice entity is not a recognized structure; the practice entity is physician-owned.
This ownership rule is legally distinct from the clinical supervisory arrangement above — the supervising physician does not need to be the entity's sole owner, only a physician (or physicians) must hold ownership/control.
Legal sources for these rules (5)
- KRS 311.854 — Approval of supervising physician; ratio cap
- KRS 311.856 — Duties of supervising physician; chart review; proximity
- KRS 311.858 — Services/procedures physician assistant may perform; prescriptive restrictions
- S.B. 116 (2026 Regular Session) — PA prescribing update (Schedule II authority)
- Kentucky Board of Medical Licensure — Physician Assistant regulated profession page
About Kentucky's rules
KY's PSC/PLLC statutes (KRS Ch. 274, 275) are commonly read to restrict ownership to persons rendering the 'same or related' professional service — a physician generally cannot co-own a single PSC/PLLC with a PA or APRN, unlike NC/VA's explicit combination statutes. Secondary-sourced interpretation, not a confirmed ruling — verify before relying on it. Kentucky opted out of the federal Medicare CRNA supervision requirement in April 2012; facilities may still impose their own.
Other clinicians in Kentucky: see the state overview.