Guiding Questions for PAs and Physicians and the Medical Practices That Employ Them

As of January 1, 2020, PAs are no longer delegated be delegated the authority to perform particular medical services. Instead, an agreement with the practice defines medical services a PA may provide within that practice.

How will practices determine if a PA is authorized to (fill in this blank with a medical service)?

Is the PA supervised? 

Supervision means that a physician oversees the activities of, and accepts responsibility for, the medical services rendered by a PA. Supervision shall not be construed to require the physical presence of a physician. 

Does the PA have a Practice Agreement? 

The Practice Agreement must be developed through collaboration among one or more physicians, defining the medical services ** the PA is authorized to perform and grants approval for one or more physicians on staff to supervise one or more PAs. 

Is there a physician electronically available at the time the PA examines the patient? 

Physician supervision is required but does not mean physical presence. Electronic availability of a physician within the practice is necessary. 

Is the PA competent to perform the services? 

At the practice level, PA competence shall be established and maintained. PAs will undergo a periodic review of their competence within their practice. 

Has the PA's education, training, and experience prepared the PA to render the services? 

At the practice level, healthcare professionals will determine that the PAs education, training, and experience have prepared the PA to provide medical services consistent with the standard of care. 


The answers to these five questions will be your guide to many questions. In general, if you answer YES to all 5 questions, then it would appear that the PA may provide that service (unless otherwise restricted by the practice and/or other provisions of CA law that may impose restrictions or conditions).

*As of January 1, 2020, there is no requirement that a physician who supervises PA(s) in the practice share a particular area of medicine or specialty.

**Pay attention to provisions of CA law that may impose restrictions or conditions.

The content of this document is being provided for general informational purposes only and is not legal advice or a substitute for legal counsel. Given that the medical services performed by PAs can vary greatly from practice to practice, the reader should contact their attorney to obtain legal advice tailored to their specific circumstances.