Supervision Agreement · PA
New York Supervisory Practice Agreement for Physician Assistants
Required. The Supervisory Practice Agreement is the written instrument New York 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 — supervision (not a 'practice agreement') is required for the life of the PA's practice. A 2024 reform (eff. Feb. 2025) raised, not removed, the supervision ratio; a pending bill (S7981/A7988) to create a 6,000-hour independence pathway remains stuck in committee as of this research.
What a New York Supervisory Practice Agreement must contain
Each numbered item is a statutory requirement the Supervisory Practice Agreement must satisfy.
The Physician Assistant ("PA") shall perform medical services only under the continuous supervision of the Physician, as required by Education Law § 6542. Supervision must be continuous but does not require the Physician's physical presence at the time or place a service is rendered.
Source: N.Y. Educ. Law § 6542
A supervising physician may not supervise more than six (6) Physician Assistants at one time in a private practice setting (no fixed numerical limit applies in a hospital setting), consistent with New York law. Consistent with that law, the Physician Assistant may prescribe durable medical equipment, issue non-patient-specific standing orders, authorize a Registered Nurse to provide non-patient-specific care such as immunizations, and write inpatient equipment orders, in each case subject to the terms of this 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
- N.Y. Educ. Law § 6542statute
Requires continuous physician supervision of a Physician Assistant's performance of medical services.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the Supervisory Practice Agreement has to carry, from New York's supervision rules.
Proximity
Available remotely (no on-site requirement)
Educ. Law §6542: supervision 'shall not be construed as necessarily requiring the physical presence of the supervising physician at the time and place where such services are performed' — no mileage/radius or on-site standard codified.
Supervision ratio
private practice: Up to 6 at a time
Educ. Law §6542, as amended by A.8378-A/S.9038-A (signed Dec. 2024, eff. Feb. 22, 2025) — raised from a prior 1:4 cap. Hospitals are entirely exempt from any numerical cap: 'nothing in this article shall prohibit a hospital from employing physician assistants' under a hospital-designated supervising physician.
NYS Dept. of Corrections and Community Supervision (DOCCS) facilities: Up to 8 at a time
Same Dec. 2024/Feb. 2025 amendment raised the DOCCS-specific cap from 1:6 to 1:8.
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
PAs may obtain their own individual DEA registration as 'mid-level practitioners.'
Written agreement
Required
Unconditional — 'supervision' under Educ. Law Article 131-B is the physician's ongoing legal responsibility for the PA, not a filed practice-agreement document comparable to the NP model. No PA-specific written-agreement form analogous to the NP's was found.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — New York has one of the strictest corporate-practice-of-medicine regimes in the country. A medical-services PLLC's members must ALL be licensed under Educ. Law Article 131 (Medicine) — N.Y. LLC Law §1203, confirmed directly against statute text; the parallel professional-service-corporation framework (Bus. Corp. Law §1503, who may organize; §1507, share issuance restricted to licensed practitioners of the authorized profession; §1506, corporation restricted to the services it was incorporated for — all three read directly and confirmed non-conflicting) works the same way. PAs are licensed under the separate Article 131-B, so — by the same logic confirmed for RNs (Article 139) below — a PA cannot be a member/owner of a medical-services PLLC/PC; PAs practice as employees of a physician-owned entity, not owners.
Sources for the supervision rules (6)
- N.Y. Educ. Law §§ 6541, 6542 (Article 131-B)
- A.8378-A/S.9038-A (2024) — raised PA supervision ratios, eff. 2/22/2025
- NYSED Office of the Professions — Article 131-B summary
- health.ny.gov — Physician Assistant reference
- S7981/A7988 (2025-26 session) — pending 6,000-hour PA independence pathway, not enacted
- 10 NYCRR § 94.2 — Supervision and scope of duties
About New York's rules
New York combines an unusually strict general corporate-practice-of-medicine regime (physician/same-profession-only PC/PLLC ownership) with two notable exceptions: pharmacy ownership is NOT restricted to pharmacists (Educ. Law §6808), and midwifery (CNM) is its own fully independent practice act (Art. 140), unlike the physician-collaboration model governing NP/PMHNP. CRNA has no dedicated practice statute at all — governed only by DOH facility regulation. NP/PMHNP independence (≥3,600 hours) is a repeatedly-extended sunset provision (currently through July 1, 2030), not permanent law.
Other clinicians in New York: see the state overview.