Supervision Agreement for Physician Assistants in Alabama

PA with <2 years (4,000 hours) of experience, remote/satellite site: On-site presence required

Supervising physician must be physically present at the approved practice site for not less than 10% of the PA's scheduled hours (Ala. Admin. Code r. 540-X-7-.23).

PA with ≥2 years (4,000 hours) of experience, remote/satellite site: Available remotely (no on-site requirement)

On-site presence requirement drops away; physician must instead visit the remote site no less than twice annually and meet with the PA at least quarterly. No mileage/radius figure could be confirmed in the rule text retrieved in this research pass — flag as unconfirmed rather than absent.

Up to 9 at a time (combined across provider types)

A physician may not collaborate with/supervise any combination of CRNPs, CNMs, and PAs exceeding 360 hours/week (i.e., 9 FTE positions total, combined across all three provider types) — a shared cap, not a per-type cap (Ala. Admin. Code r. 540-X-8-.08, cross-referenced for PAs).

Percentage set by agreement · Quarterly · countersignature required

Quarterly quality-assurance review of 'a meaningful sample of medical records plus all adverse outcomes' — no specific percentage codified. Countersignature required 'pursuant to established policy and/or applicable legal regulations and accreditation standards,' also with no fixed percentage (Ala. Admin. Code r. 540-X-7-.23, -.24). Records retained for duration of practice plus 3 years after termination.

Quarterly

Minimum quarterly meeting cadence; modality not specified as exclusively in-person or telehealth.

Covered by the practice agreement · controlled substances permitted

PAs prescribe legend drugs under the supervising physician's authority; controlled-substance prescribing appears to flow through the supervising physician's own DEA/Alabama Controlled Substances Certificate rather than a PA-specific certificate (unlike CRNP/CNM's QACSC, which by its own chapter title covers only CRNP/CNM) — this could not be fully confirmed in this research pass; recommend direct confirmation against 540-X-7's controlled-substances section.

Licensee-only ownership required — Title 10A professional-entity statutes require PC/PLLC shareholders to be licensed to render 'the same specific professional services' as the entity — as a practical matter a PA cannot be the sole licensed owner of a medical practice entity (secondary-sourced characterization of Title 10A; not independently confirmed against primary statutory text in this research pass).

Alabama has no strict corporate-practice-of-medicine doctrine barring corporate ownership generally, but PAs cannot own/operate an independent practice outside a registered supervising-physician relationship.