Practice Agreement · PA
Physician Assistant Practice Agreement in Massachusetts
Massachusetts 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.
MA has no independent-practice pathway for PAs — 243 CMR 2.08 requires ongoing physician supervision for the PA's full career, regardless of experience. No NC/VA-style autonomous-practice reform exists in MA as of this writing.
What a Physician Assistant practice agreement covers in Massachusetts
Governed by the Massachusetts Board of Registration in Medicine and the Massachusetts Board of Registration in Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Physician Assistant ("PA") shall practice under the continuous supervision of the Physician, as required by M.G.L. c. 112 §§ 9E-9I and 263 CMR 5.00. Supervision does not require the Physician's physical presence. The scope of practice and prescriptive parameters shall be set by guidelines mutually developed by the Physician and the Physician Assistant.
Massachusetts law does not fix a numerical limit on the number of Physician Assistants one physician may supervise; the adequacy of supervision is instead assessed by a multi-factor test considering geographic proximity, practice setting, patient volume and complexity, and the experience of the physician and the Physician Assistant.
- The agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- 247 CMR 16.00regulation
Massachusetts Board of Registration in Pharmacy regulation on collaborative drug therapy management, implementing M.G.L. c. 112, §§ 24B1/2–24B3/4.
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)
243 CMR 2.08(5)(a): supervision 'does not require the physical presence of the supervising physician' whenever the PA renders services; no mile/minute radius is codified. Diagnostic/treatment information must still be reviewed 'in a timely manner consistent with the patient's medical condition' — a continuous duty, not a fixed percentage quota.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
PA has prescriptive practice authority: Quarterly
Supervising physician must review the PA's prescriptive practice at least every three months (243 CMR 2.08(6)).
review of the written prescriptive-practice guidelines themselves: Annually
Guidelines must be reviewed, dated, and initialed by both the PA and supervising physician at least annually (243 CMR 2.08(6)).
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Schedule II–V per mutually-developed written guidelines; Schedule II prescriptions specifically require supervising-physician review within 96 hours of issuance (243 CMR 2.08(6)). Requires MA Controlled Substance Registration and DEA registration; opioid prescribing must comply with MassPAT (M.G.L. c. 94C).
Written agreement
Required
MA does not require a single freestanding 'supervision agreement' document the way some states do — a PA registers a supervising physician with the Board, and written, mutually-developed 'guidelines' are specifically required for prescriptive practice (243 CMR 2.08(6)). Treated here as agreementRequired=True because prescriptive guidelines are the practical equivalent for any prescribing PA.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Corporation under M.G.L. c. 156A — Massachusetts is widely described as having one of the strictest corporate-practice-of-medicine regimes in the country, generally limiting ownership of a medical practice entity to licensed physicians. Whether PAs have any independent-ownership pathway under c. 156A specifically was not confirmed from primary text in this research pass — treat as unresolved, the same open item VA's file flags for PAs under its own PC/PLLC statutes.
These exceptions are the commonly-cited categories in MA CPOM commentary; not independently re-verified against current statutory text in this pass.
Legal sources for these rules (2)
About Massachusetts's rules
Full practice authority (Acts 2020, c. 260, §36; 244 CMR 4.00) let NPs, PMHNPs, and CNMs practice independently in MA — CNMs immediately, NPs/PMHNPs after a Board-attested transition (244 CMR 4.07). PAs and CRNAs have no independent-practice pathway. MA's professional-corporation ownership rules (M.G.L. c. 156A) are notably strict; this file could not independently re-verify APRN/PA-specific PLLC eligibility this pass — treat CPOM entries as open items.
Other clinicians in Massachusetts: see the state overview.