Frequently Asked Questions

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Frequently Asked Questions

Supervising Physician Assistants

Does a physician need approval to supervise a Physician Assistant?

No, a physician does not need approval from the Board to supervise a Physician Assistant. The physician must have a current medical license and there must not be any limitations on the medical license that prohibits the supervision of Physician Assistants.

How many Physician Assistants can a physician supervise?

The law limits a physician to supervise no more than four Physician Assistants.

What is the scope of practice of a Physician Assistant?

The scope of a Physician Assistant is limited by their supervising physician. Whatever medical specialty a physician practices (e.g., general practice, cardio-thoracic surgery, dermatology, etc.) limits the Physician Assistant's scope of practice. The Delegation of Services Agreement between the Physician Assistant and the supervising physician further defines exactly what tasks and procedures a physician is delegating to the Physician Assistant. These tasks and procedures must be consistent with the supervising physician's specialty or usual and customary practice and with the patient's health and condition.

Before authorizing a Physician Assistant to perform any medical procedure, the physician is responsible for evaluating the Physician Assistant's education, experience, knowledge, and ability to perform a procedure safely and competently. In addition, the physician should verify that the Physician Assistant has a current California license issued by the Physician Assistant Board.

A Physician Assistant may not perform any of the following medical services pursuant to Business and Professions Code (BPC) section 3502 (d):

  • The determination of the refractive states of the humman eye, or the fitting or adaptation of lenses or frames;
  • The prescribing or directing the use of, or using any optical device in connection with ocular exercises, visual training or orthoptics;
  • The prescribing, fitting or adaptation of contact lenses and
  • The practice of dentistry or dental hygiene or the work of a dental auxiliary.

A Physician Assistant may perform a routine visual screening pursuant to BPC section 3501(h) as a noninvasive, nonpharmacological simple testing for visual acuity, visual field defects, color blindness, and depth perception.

How do I verify a Physician Assistant's license?

You can verify a Physician Assistant's license on-line at: pab.ca.gov, or by calling the Physician Assistant Board at (916) 561-8780.

What documents are required to supervise a Physician Assistant?

Pursuant to the Business and Professions Code section 3502.3, a practice agreement with the provisions listed below must be obtained;

The agreement must define exactly what tasks and procedures the Physician Assistant is authorized to perform; policies and procedures to ensure adequate supervision of the Physician Assistant; methods for the continuing evaluation of the competency and qualifications of the Physician Assistant; the furnishing or ordering of drugs or devices by a Physician Assistant; and any additional provisions agreed to by the Physician Assistant and physician. The agreement must be completed before the Physician Assistant starts practicing. The agreement does not need to be submitted to the Board.

Can a Physician Assistant practice independently?

No, a Physician Assistant cannot practice independently. Every Physician Assistant must be supervised by a licensed physician (either M.D. or D.O.). The supervising physician is responsible for all medical services provided by the Physician Assistant under their supervision and for following each patient's progress.

What supervision is required for a Physician Assistant?

The supervising physician oversees the activities of and accepts responsibility for the medical services rendered by the Physician Assistant. The supervising physician is required to adhere to the following mechanisms to provide supervision:

  1. Adherence to adequate supervision as agreed to in a practice agreement that meets the requirements of Business and Professions Code section 3502.3.
  2. The physician must be available by telephone or other electronic communication method at the time the Physician Assistant examines the patient.

Business and Professions Code section 3501

Is the supervising physician required to be on-site when the Physician Assistant is practicing?

No, the supervising physician is not required to be on site when the Physician Assistant is practicing; however, the supervising physician but must be available in person or by electronic communication at all times. If the Physician Assistant is performing a surgical procedure that requires general anesthesia, the supervising physician must be immediately available during the procedure. Pursuant to Title 16 of the California Code of Regulations section 1399.541, “Immediately available” means that the supervising physician is “physically accessible and able to return to the patient, without any delay, upon the request of the physician assistant to address any situation requiring the supervising physician’s services.”

Are Physician Assistants allowed to write drug orders?

Yes, Physician Assistants are authorized to order or furnish a drug, pursuant to Business and Professions Code section 3502.1. Physician Assistants may also administer or provide medication to a patient. The supervising physician must delegate that authority to the Physician Assistant in the delegation of services agreement. When ordering a drug, the Physician Assistant is acting on behalf of, and as an agent for, the supervising physician.

Before a Physician Assistant can order a drug, the supervising physician must first prepare and adopt a written, practice specific formulary and protocols that specify all criteria for the use of a particular drug and any contraindications. The drugs listed constitute the formulary and may only include drugs that are appropriate for use in the practice.

Any variations require advance approval from the supervising physician for the particular patient before the Physician Assistant may issue a drug order.

What information must be on a Physician Assistant's drug order?

Pursuant to Business and Professions Code section 3502.1 (d), a drug order must contain the supervising physician’s name, address, phone number, signature, printed or stamped name, and the license number of the Physician Assistant. If the drug order is for a controlled substance, it must also include the DEA number.

Is a Physician Assistant allowed to issue drug orders for controlled substances?

Yes, a Physician Assistant may issue drugs orders for Schedule II through V controlled substances, if the supervising physician delegates that authority to the Physician Assistant. However, the Physician Assistant must complete an approved education course in controlled substances. Existing law allows two mechanisms for reviewing and signing off on medical charts for Schedule II drug orders:

  • The first requires the medical charts for these drug orders to be countersigned within seven days by the supervising physician.
  • • The second is only allowed if the Physician Assistant has documentation evidencing the successful completion of an education course that covers controlled substances and meets specified standards. This mechanism requires the supervising physician to review, countersign, and date within seven days, a sample consisting of the medical records of at least 20 percent of the patients cared for by the Physician Assistant for whom the Schedule II drug order has been issued or carried out.

A PA that is authorized to issue drug orders for controlled substances must register with the United States Drug Enforcement Administration (DEA) and obtain a DEA number.

Can the Physician Assistant use the supervising physician's DEA number on drug orders for controlled substances?

No, a Physician Assistant may not use the supervising physician’s Drug Enforcement Administration (DEA) number. The Physician Assistant are required to register with the United States DEA and obtain their own DEA number if they will issue drug orders for controlled substances.

Can a Physician Assistant perform surgery?

Yes, a Physician Assistant may perform surgery if the supervising physician has allowed it and it is included in the Physician Assistant’s practice agreement. If authorized by the practice agreement, a Physician Assistant may perform surgical procedures under local anesthesia without the personal presence of the supervising physician. A Physician Assistant may perform surgical procedures requiring other forms of anesthesia if authorized by the practice agreement and only when the supervising physician is “immediately available” as defined by Title 16 of the California Code of Regulations section 1399.541. A Physician Assistant may act as first, or second, assistant in surgery under the supervision of the supervising physician.

Can a Physician Assistant evaluate a patient for the medical use of Marijuana?

A Physician Assistant can evaluate a patient for the medical use of marijuana consistent with the Physician Assistant's delegation of services agreement. However, only a physician is authorized to recommend medical use of marijuana, pursuant to Health and Safety code section 11362.5.

Health and Safety Code section 11362.7 (a) sets forth the definition of "attending physician" for purposes of the Compassionate Use Act. It states that the attending physician shall complete a medical examination before providing a recommendation for medical marijuana (emphasis added). A physician assistant may perform an examination and give an evaluation of the patient. In addition to personally completing the medical examination, the attending physician himself or herself must record in the patient's medical record their assessment of whether the patient has a serious medical condition and whether the medical use of marijuana is appropriate.

For additional information about the Medical Marijuana Program, please visit the Department of Public Health website.

For additional information for physicians who wish to recommend medical marijuana as part of their regular practice of medicine please visit the Medical Board of California's website.

Can Medical Assistants be supervised by a Physician Assistant in the absence of a supervising physician?

Pursuant to Business and Professions Code section 2069 (a)(1), a supervising physician and surgeon at a "community clinic" licensed under Health and Safety Code section 1204(a) may, at their discretion, in consultation with the nurse practitioner, nurse midwife, or physician assistant provide written instructions to be followed by a medical assistant in the performance of tasks or supportive services. The written instructions may provide that the supervisory function for the medical assistant in performing these tasks or supportive services may be delegated to the nurse practitioner, nurse midwife, or physician assistant and that those tasks may be performed when the supervising physician and surgeon is not on site.