Supervision Agreement · PA
Tennessee Supervisory Practice Agreement for Physician Assistants
Required. The Supervisory Practice Agreement is the written instrument Tennessee 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.
PAs have no independent-practice pathway. The Board of Medical Examiners regulates PA supervision under a structure parallel to the NP collaboration rules; the chart-review and site-visit figures below follow that parallel NP framework and should be confirmed against the PA chapter.
What a Tennessee Supervisory Practice Agreement must contain
Each numbered item is a statutory requirement the Supervisory Practice Agreement must satisfy.
The Physician Assistant ("PA") shall designate the Physician as the Physician Assistant's primary collaborating physician, and may designate one or more alternates, as required by Tenn. Code Ann. §§ 63-19-106 and 63-19-107. Tennessee law does not fix a numerical limit on the number of Physician Assistants with whom a physician may collaborate; the number is left to the Physician's judgment consistent with good medical practice standards.
The Physician Assistant shall notify the Tennessee Committee on Physician Assistants of the primary collaborating physician's name, address, and license number, and shall report any change within fifteen (15) days.
- 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 Tennessee's supervision rules.
Proximity
On-site presence required
Follows Tennessee's parallel APRN rule requiring the collaborating or supervising physician to make an in-person visit to a remote practice site every 30 days (up to 10 of the required annual visits may occur via HIPAA-compliant telehealth); confirm against Tenn. Comp. R. & Regs. Ch. 1130-01 that the same cadence applies to PA supervision.
Supervision ratio
Not codified — no cap on file
Chart review
20% of charts · Monthly · countersignature required
Follows Tennessee's parallel APRN chart-review rule (the physician must personally review at least 20% of charts every 30 days, plus 100% of controlled-substance charts, with additional review every 10 business days under specified trigger conditions); confirm against Tenn. Comp. R. & Regs. Ch. 1130-01 that it applies identically to PA supervision.
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Secondary sources disagree on whether the range is Schedule II–V or II–IV; confirm current scope with the Board before relying on this for a specific prescription.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation or PLLC 100% owned by physicians licensed in Tennessee; a professional corporation may practise only a single profession, so a PA cannot co-own the PC even alongside physicians
Violating TN's Practice of Medicine statute (TCA § 63-6-204) is a Class B misdemeanor.
Sources for the supervision rules (3)
- Tenn. Code Ann. § 63-6-204 — Practice of Medicine Act (corporate practice of medicine)
- Tenn. Comp. R. & Regs. Ch. 1130-01 — General Rules Governing the Practice of a Physician Assistantsecondary
- Permit Health — Tennessee Corporate Practice of Medicine (CPOM) Guidesecondary
About Tennessee's rules
TN is a restricted-practice state for NPs — no independence pathway exists. Physicians must personally review ≥20% of an APRN's charts every 30 days (100% of controlled-substance charts) and visit remote practice sites in person every 30 days. TN has an explicit, unambiguous corporate-practice-of-medicine ban (statute, case law, and AG opinions; TCA § 63-6-204) — a professional corporation may practice only a single profession.
Other clinicians in Tennessee: see the state overview.