1. (a) The written agreement required by section 13(e) of the act (63 P.S. § 422.13(e)) satisfies the following requirements. The agreement must:

   1. (1) Identify and be signed by the physician assistant and the primary supervising physician. The primary supervising physician shall be a medical doctor.
   2. (2) Describe the physician assistant’s scope of practice.
   3. (3) Describe the nature and degree of supervision the supervising physician will provide the physician assistant.
   4. (4) Be prepared and submitted by the primary supervising physician, the physician assistant or a delegate of the primary supervising physician and the physician assistant. It shall not be a defense in any administrative or civil action that the physician assistant acted outside of the scope of the Board-filed description or that the supervising physician utilized the physician assistant outside of the scope of the Board-filed description because the supervising physician or physician assistant permitted another person to represent to the Board that the description had been approved by the supervising physician or physician assistant.

   5. (5) Require that the supervising physician shall countersign the patient record as outlined in the written agreement and as provided for as follows:

      1. (i) The primary supervising physician shall determine countersignature requirements of patient records completed by the physician assistant in a written agreement, except as provided for in subparagraph (ii).

      2. (ii) The primary supervising physician shall countersign 100% of patient records completed by the physician assistant within a reasonable time, which may not exceed 10 days, during the following periods:

         1. (A) The first 12 months of the physician assistant’s practice post-graduation and after the physician assistant has fulfilled the criteria for licensure set forth in section 36(c) of the act (63 P.S. § 422.36(c)).
         2. (B) The first 12 months of the physician assistant’s practice in a new specialty in which the physician assistant is practicing.
   6. (6) Identify the primary practice setting where the physician assistant will serve.
   7. (7) Name at least one substitute supervising physician if the physician assistant intends to practice if the primary supervising physician is permanently unable to supervise.
2. (b) The written agreement shall be filed with the Board and shall be effective upon submission to the Board by the primary supervising physician, physician assistant or a delegate of the primary supervising physician and physician assistant.
3. (c) Upon request, a physician assistant or supervising physician shall provide access to the written agreement to confirm the scope of the physician assistant’s authority.

Authority

The provisions of this § 18.142 amended under sections 8, 13 and 36 of the Medical Practice Act of 1985 (63 P.S. § § 422.8, 422.13 and 422.36); and sections 502 and 503 of the Vital Statistics Law of 1953 (35 P.S. § § 450.502 and 450.503).

Source

The provisions of this § 18.142 amended August 13, 1993, effective August 14, 1993, 23 Pa.B. 3780; amended November 17, 2006, effective November 18, 2006, 36 Pa.B. 7009; amended July 3, 2025, effective July 5, 2025, 55 Pa.B. 4534. Immediately preceding text appears at serial pages (421175) to (421176).

Cross References

This section cited in 49 Pa. Code § 18.122 (relating to definitions); 49 Pa. Code § 18.143 (relating to criteria for registration as a supervising physician); 49 Pa. Code § 18.153 (relating to executing and relaying medical regimens); 49 Pa. Code § 18.156 (relating to monitoring and review of physician assistant utilization); 49 Pa. Code § 18.158 (relating to prescribing and dispensing drugs, pharmaceutical aids and devices); and 49 Pa. Code § 18.159 (relating to medical records).