Supervision Agreement · PA
Iowa Supervisory Practice Agreement for Physician Assistants
Required. The Supervisory Practice Agreement is the written instrument Iowa 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 exists for PAs in Iowa — physician supervision under a supervision agreement is required for as long as the PA practices (Iowa Code Ch. 148C).
What an Iowa Supervisory Practice Agreement must contain
Each numbered item is a statutory requirement the Supervisory Practice Agreement must satisfy.
Unless the Physician Assistant ("PA") has practiced under physician supervision or in collaboration with an appropriate health care professional for at least two (2) years, the Physician Assistant shall practice under the supervision of the Physician, who shall remain accessible at all times for consultation, as required by Iowa Code §§ 148C.3 and 148C.5. Physical presence of the Physician is not required. A physician may not supervise more than five (5) Physician Assistants at one time.
Source: Iowa Admin. Code r. 481-780.8(3)
Once the Physician Assistant has practiced under supervision or in collaboration for at least two (2) years, as permitted by 2023 Iowa Acts chapter 73, the Physician Assistant may instead practice through team-based collaboration, with the degree of collaboration determined at the practice or facility level rather than fixed by a supervisory agreement.
- The Supervisory Practice Agreement also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
Statutes and rules these clauses cite
- Iowa Admin. Code r. 481-780.8(3)regulation
Limits a supervising physician to no more than five Physician Assistants supervised at the same time.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the Supervisory Practice Agreement has to carry, from Iowa's supervision rules.
Proximity
Available remotely (no on-site requirement)
Supervision does not require the supervising physician's personal presence where services are rendered, except as expressly required by Ch. 148C or board rule (Iowa Admin. Code 481—780.8). No fixed mile/minute radius is codified.
Supervision ratio
Up to 5 at a time
No more than 5 PAs may be supervised by a physician at the same time (Iowa Admin. Code 481—780.8(3)).
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Prescriptive scope is addressed in the supervision agreement; Iowa statute does not state a PA-specific schedule limit.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation under Iowa Code Ch. 496C, or PLLC — Iowa's 'lawful combination' rule lets physicians (MD/DO) and PAs co-own the same entity; nurse practitioners are not included in that combination and generally cannot co-own a physician-PA entity.
Ownership is legally distinct from the clinical supervisory relationship above.
About Iowa's rules
Iowa APRNs (NP/CRNA/CNM/CNS) may practice, diagnose, and independently prescribe (including controlled substances, with DEA/Board of Pharmacy registration) with no collaborative agreement required by the Board of Nursing — a voluntary agreement is permitted but optional. PAs remain supervised_only under a 5-PA-per-physician cap (Iowa Code Ch. 148C).
Other clinicians in Iowa: see the state overview.