PA · Kentucky
Supervision Agreement for Physician Assistants in Kentucky
Yes, a written supervising-physician agreement is required. Kentucky does not name a specific instrument.
PAs may not practice medicine independently in Kentucky at any level of experience — no autonomous/team-based-practice reform comparable to NC's or VA's has been enacted here. A supervising physician must be Board-approved for each PA supervised (KRS 311.854), and remains responsible for the PA's actions for as long as the relationship continues.
What the supervision must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Available remotely (no on-site requirement)
KRS 311.856 permits a PA to practice at a location separate from the supervising physician if the physician remains continuously available by telecommunication; no mile/minute radius is codified. 'Adequate, active, and continuous supervision' is the statutory standard, undefined further by rule.
Supervision ratio
Up to 4 at a time
A physician may not supervise more than 4 PAs at any one time (KRS 311.854), each requiring separate Board approval. Tighter than NC's (uncapped) and VA's (6) PA ratios.
Chart review
Percentage set by agreement · As needed · countersignature required
KRS 311.856 requires the supervising physician to review and countersign 'a sufficient number of overall medical notes' to ensure quality of care, but leaves both the percentage and the review cadence to be 'determined by the supervising physician, practice, or institution' — no statutory number or frequency exists to cite; AS_NEEDED reflects that the statute itself sets no fixed cadence, not that review is optional.
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Schedule II authority (added by S.B. 116) and Schedules III–V require ≥1 year of licensed PA practice, a Board application signed by the supervising physician, Board approval, individual DEA registration, and KASPER (PDMP) enrollment — all on top of, and delegated within, the general supervision agreement (KRS 311.858).
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Service Corporation (KRS Ch. 274) — ownership is restricted to persons licensed to render the corporation's specific professional service. A PA is not licensed to independently render medical services (KRS 311.858 requires practice as an agent of a supervising physician), so an independent PA-owned medical-practice entity is not a recognized structure; the practice entity is physician-owned.
This ownership rule is legally distinct from the clinical supervisory arrangement above — the supervising physician does not need to be the entity's sole owner, only a physician (or physicians) must hold ownership/control.
Legal sources for these rules (5)
- KRS 311.854 — Approval of supervising physician; ratio cap
- KRS 311.856 — Duties of supervising physician; chart review; proximity
- KRS 311.858 — Services/procedures physician assistant may perform; prescriptive restrictions
- S.B. 116 (2026 Regular Session) — PA prescribing update (Schedule II authority)
- Kentucky Board of Medical Licensure — Physician Assistant regulated profession page
What a supervising physician costs here
Typical monthly cost in Kentucky
$550 – $850
Estimate for one Physician Assistant. This state's proximity rules add a small premium.
About Kentucky's rules
KY's PSC/PLLC statutes (KRS Ch. 274, 275) are commonly read to restrict ownership to persons rendering the 'same or related' professional service — a physician generally cannot co-own a single PSC/PLLC with a PA or APRN, unlike NC/VA's explicit combination statutes. Secondary-sourced interpretation, not a confirmed ruling — verify before relying on it. Kentucky opted out of the federal Medicare CRNA supervision requirement in April 2012; facilities may still impose their own.
Other clinicians in Kentucky: see the state overview.