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Practice Agreement · PA

Physician Assistant Practice Agreement in Montana

Montana 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.

Practice authorityConditional independence
Written agreementAgreement required
What Montana calls itNo named instrument
Governing boardMontana Board of Medical Examiners and the Montana Board of Pharmacy
Agreement familySupervising Physician
Research date2026-09-03 · clauses 2026-09-03

Below 8,000 hours, a PA must practice under a written collaborative agreement with a physician OR with another PA who has 8,000+ hours (§ 37-20-203, MCA) — unusual among researched states in letting a PA-to-PA relationship satisfy the requirement. No numeric ratio cap is codified.

Independent practice requires: ≥8,000 hours of postgraduate clinical experience as a PA (or already actively practicing with 8,000+ hours before October 1, 2023).

What a Physician Assistant practice agreement covers in Montana

Governed by the Montana Board of Medical Examiners and the Montana Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.

  1. Unless the Physician Assistant ("PA") has eight thousand (8,000) or more hours of postgraduate clinical practice, the Physician Assistant shall practice in collaboration with the Physician or with a Physician Assistant who has eight thousand (8,000) or more hours of postgraduate clinical practice, as provided under Mont. Code Ann. § 37-20-203. A Physician Assistant actively practicing for 8,000 hours prior to October 1, 2023 is exempt from the collaborative agreement requirement. Once the Physician Assistant reaches the eight thousand (8,000) hour threshold, the Physician Assistant is exempt from the collaborative-agreement requirement, but shall continue to collaborate with the health care team and consult or refer as appropriate.

    Source: Mont. Code Ann. § 37-20-203

  2. Where a collaboration agreement is required, the Physician and the Physician Assistant shall develop written policies and procedures governing the collaborative relationship, specifying how collaboration will occur and the methods the Physician will use to evaluate the Physician Assistant's competency, knowledge, and skills, and shall produce that documentation to the Montana Board of Medical Examiners upon request.

    Source: Mont. Code Ann. § 37-20-203

  3. The agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.

Statutes and rules cited

  1. Mont. Code Ann. § 37-8-409statute

    Conditions under which an advanced practice registered nurse may practice; current text contains no physician collaboration or supervision agreement requirement.

  2. Mont. Code Ann. § 37-20-203statute

    Physician assistant collaborative agreement requirement below 8,000 hours of postgraduate clinical experience, and exemption once that threshold is met.

  3. Mont. Code Ann. § 37-7-101statute

    Definitions of collaborative pharmacy practice and collaborative pharmacy practice agreement under the Montana Pharmacy Practice Act.

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

Not codified — left to the agreement

Supervision ratio

Not codified — no cap on file

Chart review

Not codified — left to the agreement

Meeting cadence

Not codified — left to the agreement

Prescriptive authority

Covered by the practice agreement · controlled substances permitted

No separate agreement beyond the general collaborative agreement is required to prescribe — prescriptive authority flows from the PA's own license once collaboration (if below the 8,000-hour threshold) is in place.

Written agreement

Required

Practice ownership (corporate practice of medicine)

Licensee-only ownership required — Montana Professional Corporation Act (Title 35, ch. 4, MCA) restricts shares in a professional corporation to 'qualified persons' licensed in the service the corporation renders; Montana repealed its explicit corporate-practice-of-medicine statute in 1995, but Board of Medical Examiners rule still treats practicing medicine in partnership/joint venture with an unlicensed person as unprofessional conduct.

Whether a PA can independently own the entity they practice through (vs. co-owning with a physician) was not confirmed in current statute — flagged as uncertain rather than asserted either way.

Legal sources for these rules (5)
How the relationship works day to day
Who has to be where, how often you meet, and what the physician costs: Physician Assistant in Montana on collaborativeagreement.com.

About Montana's rules

House Bill 810 (2023) would have imposed a 2-year physician/NP-collaboration requirement on APRNs; it was referred to committee and this research could not confirm it became law — current APRN statute text found shows no such requirement, so NP/CRNA/CNM/CNS are coded as independent, but verify this hasn't changed before relying on it. Montana repealed its corporate-practice-of-medicine statute in 1995; CPOM entries below reflect residual board rule, not a clear statutory line.

Other clinicians in Montana: see the state overview.