1. A. Before a physician assistant may perform medical acts, the physician assistant shall:

   1. (1) Execute a collaboration agreement between the physician assistant and one or more patient care team physicians;
   2. (2) Notify the Board in a manner approved by the Board of the executed collaboration agreement; and
   3. (3) Maintain a copy of the executed collaboration agreement on file at the physician assistant’s primary practice location.

2. B. Collaboration Agreement Requirements.

   1. (1) A collaboration agreement may only consist of one physician assistant and one or more patient care team physicians practicing at the same facility.
   2. (2) A physician assistant shall have a separate collaboration agreement for each of the physician assistant’s employers.
   3. (3) The physician assistant has the affirmative obligation to retain the collaboration agreement and all of the documentation pertaining to the collaboration agreement for 5 years after termination of the collaboration agreement for Board inspection.

3. C. Contents.

   1. (1) The collaboration agreement shall include, at minimum:

      1. (a) Each patient care team physician’s name and Maryland license number;
      2. (b) A description of each patient care team physician’s qualifications to collaborate with a physician assistant;
      3. (c) The practice specialty of each listed patient care team physician;
      4. (d) The physician assistant’s name and Maryland license number;
      5. (e) The primary location and settings where the physician assistant will practice;
      6. (f) The employer of the physician assistant;
      7. (g) A description of the settings where the physician assistant will practice;
      8. (h) Any delegation of prescriptive authority and, if applicable, dispensing according to Regulation .08 of this chapter; and
      9. (i) Any other information deemed necessary by the Board to carry out the provisions of Health Occupations Article, Title 15, Annotated Code of Maryland.

   2. (2) The collaboration agreement may include a description of any provisions established by the listed patient care team physicians that:

      1. (a) Detail the practice of the physician assistant;
      2. (b) Limit the physician assistant's scope of practice; or
      3. (c) Specify office procedures.

4. D. The physician assistant shall attest that:

   1. (1) All medical acts performed by the physician assistant shall be:

      1. (a) Appropriate to the education, training, and experience of the physician assistant;
      2. (b) Customary to the practice of a patient care team physician listed on the collaboration agreement; and
      3. (c) Performed in a manner consistent with the collaboration agreement; and
   2. (2) Any performance of an advanced duty in collaboration with a patient care team physician shall be in accordance with Health Occupations Article, §15-302.1, Annotated Code of Maryland.
5. E. Each collaborating physician shall document their official acknowledgment of their understanding and status as a listed patient care team physician on the collaboration agreement with the physician assistant.

Authority: Health Occupations Article, §§1-213, 1-606, 14-205, 15-101—15-502, Annotated Code of Maryland

Effective date: May 28, 1975 (2:12 Md. R. 870)

Chapter revised effective October 26, 1981 (8:21 Md. R. 1708)

Regulations .02 and .05F amended effective September 27, 1982 (9:19 Md. R. 1895)

Regulations .05B-1 and .09A-1 adopted effective September 27, 1982 (9:19 Md. R. 1895)

Regulations .01—.11 repealed effective March 18, 1991 (18:5 Md. R. 594)

Regulations .01—.12 adopted effective March 18, 1991 (18:5 Md. R. 594)

Regulations .02, .03, .06, .10, and .11 amended; Regulations .07—.09 and .12 repealed; and new Regulations .07—.09, .12, and .15 adopted as an emergency provision effective August 12, 1999 (26:18 Md. R. 1369); amended permanently effective January 24, 2000 (27:1 Md. R. 76)

Regulations .02 and .05—.07 amended and new Regulation .06-1 adopted as an emergency provision effective November 8, 1996 (23:24 Md. R. 1676); emergency status expired October 1, 1997

Regulation .02B amended effective October 2, 1997 (24:17 Md. R. 1214); July 12, 1999 (26:14 Md. R. 1082)

Regulation .04B amended effective July 12, 1999 (26:14 Md. R. 1082)

Regulation .05B amended effective October 2, 1997 (24:17 Md. R. 1214)

Regulation .06C amended effective November 22, 1993 (20:23 Md. R. 1804); October 2, 1997 (24:17 Md. R. 1214)

Regulation .06D adopted effective October 2, 1997 (24:17 Md. R. 1214)

Regulation .07A amended effective September 11, 1995 (22:18 Md. R. 1399)

Regulation .07C adopted effective October 2, 1997 (24:17 Md. R. 1214)

Regulation .11B amended effective April 25, 1994 (21:8 Md. R. 673)

Regulation .13 adopted effective July 12, 1999 (26:14 Md. R. 1082)

Regulation .14 adopted effective July 12, 1999 (26:14 Md. R. 1082)

Chapter revised effective May 1, 2004 (31:7 Md. R. 584)

Regulation .06D adopted as an emergency provision effective October 1, 2006 (33:24 Md. R. 1905); adopted permanently effective January 15, 2007 (34:1 Md. R. 32)

Regulation .08C amended as an emergency provision effective October 1, 2006 (33:24 Md. R. 1905); amended permanently effective January 15, 2007 (34:1 Md. R. 32)

Regulation .09C amended as an emergency provision effective October 1, 2006 (33:24 Md. R. 1905); amended permanently effective January 15, 2007 (34:1 Md. R. 32)

Chapter revised as an emergency provision effective August 18, 2011 (38:19 Md. R. 1146); revised permanently effective October 3, 2011 (38:20 Md. R. 1202)

Regulation .05C amended effective January 18, 2016 (43:1 Md. R. 14)

Regulation .05F adopted effective November 7, 2016 (43:22 Md. R. 1221)

Regulation .07 amended effective January 18, 2016 (43:1 Md. R. 14)

Regulation .07A amended effective March 26, 2018 (45:6 Md. R. 320)

Regulation .09 amended effective January 2, 2017 (43:26 Md. R. 1446)

Regulation .09E adopted as an emergency provision effective January 4, 2022 (49:4 Md. R. 299); emergency status expired effective July 3, 2022

Regulation .17 adopted effective July 22, 2013 (40:14 Md. R. 1175)

Regulation .18 adopted effective July 22, 2013 (40:14 Md. R. 1175)

Chapter revised effective January 5, 2026 (52:26 Md. R. 1309)

Annotation: COMAR 10.32.03 cited in Attorney General Opinion No. 86-008 (February 18, 1986)