Supervision Agreement · PA
Kansas Supervisory Practice Agreement for Physician Assistants
Required. The Supervisory Practice Agreement is the written instrument Kansas 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 or experience-based autonomy pathway exists for PAs in Kansas — the 2022 APRN reform (H.B. 2279) applies only to nurse-licensed APRNs, not PAs, who remain under K.S.A. 65-28a05 et seq.'s physician-direction-and-supervision framework indefinitely.
What a Kansas Supervisory Practice Agreement must contain
Each numbered item is a statutory requirement the Supervisory Practice Agreement must satisfy.
The Physician Assistant ("PA") shall practice under the supervision of the Physician, as required by KSA 65-28a01 et seq., and the Physician shall file notice of intent to supervise the Physician Assistant with the Kansas State Board of Healing Arts. A supervising physician may not supervise more than the equivalent of two (2) full-time Physician Assistants at one time, except that this limit does not apply to services performed in a medical care facility as defined by KSA 65-425.
Effective after January 1, 2027, under House Bill 2702 (2026), this ratio limit no longer applies to a Physician Assistant who has reached four thousand (4,000) hours of clinical practice, and the relationship is instead characterized as collaboration rather than supervision.
- The Supervisory Practice Agreement also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the Supervisory Practice Agreement has to carry, from Kansas's supervision rules.
Proximity
Available remotely (no on-site requirement)
K.A.R. 100-28a-10 requires the supervising physician to arrange a substitute supervising physician whenever temporarily absent, unreachable by telecommunication, or otherwise unavailable — implying a telecommunication-availability standard rather than an on-site or fixed-radius one. No mile/minute radius is codified.
Supervision ratio
Up to 2 at a time
The Board limits a responsible physician to supervising the equivalent of 2 full-time PAs at one time by default; the Board may approve up to 5 PAs across different practice locations if the physician demonstrates the PAs' combined hours don't exceed 200/week and adequate supervision is achievable (K.A.R. 100-28a-10).
Chart review
first 30 days under a new supervising physician: 100% of charts · As needed (within 7 days of each encounter) · countersignature required
K.A.R. 100-28a-10 requires the supervising physician to review and authenticate ALL medical records of patients evaluated/treated by the PA within 7 days, during the PA's first 30 days with that physician.
ongoing, after the first 30 days: Percentage set by agreement · As needed
No fixed percentage or cadence is codified after the initial 30-day period — the physician must document periodic review/evaluation of the PA's performance, with specifics left to the written agreement (K.A.R. 100-28a-10).
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Schedule II: written prescription required, except oral/telephonic in an emergency followed by a written prescription within 7 days. Schedule III-V: may be prescribed orally, telephonically, or in writing. Requires the PA's own DEA registration; authority must be specified in the written agreement and within the supervising physician's normal practice (K.S.A. 65-28a08).
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation or LLC owned by licensed professionals; Kansas permits a combined entity of MDs, DOs, registered nurses, physician assistants, occupational therapists, audiologists and speech-pathologists (secondary summary)
This ownership question is legally distinct from the clinical supervisory relationship below.
Sources for the supervision rules (4)
About Kansas's rules
Senate Sub. for H.B. 2279 (eff. July 1, 2022) made Kansas a full-practice-authority state for all APRN categories (NP/PMHNP/CRNA/CNM/CNS) — no collaborative practice agreement, supervising physician, or prescribing protocol is required, with no experience threshold. The Kansas Medical Society has publicly disputed how far Board of Nursing regulations implementing this reform extend, calling some language an unauthorized expansion into medical practice — an unresolved legal/political dispute, not settled law. PAs are unaffected by this reform and remain supervised.
Other clinicians in Kansas: see the state overview.