PA · Massachusetts
Supervision Agreement for Physician Assistants in Massachusetts
Yes, a written supervising-physician agreement is required. Massachusetts does not name a specific instrument.
MA has no independent-practice pathway for PAs — 243 CMR 2.08 requires ongoing physician supervision for the PA's full career, regardless of experience. No NC/VA-style autonomous-practice reform exists in MA as of this writing.
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)
243 CMR 2.08(5)(a): supervision 'does not require the physical presence of the supervising physician' whenever the PA renders services; no mile/minute radius is codified. Diagnostic/treatment information must still be reviewed 'in a timely manner consistent with the patient's medical condition' — a continuous duty, not a fixed percentage quota.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
PA has prescriptive practice authority: Quarterly
Supervising physician must review the PA's prescriptive practice at least every three months (243 CMR 2.08(6)).
review of the written prescriptive-practice guidelines themselves: Annually
Guidelines must be reviewed, dated, and initialed by both the PA and supervising physician at least annually (243 CMR 2.08(6)).
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Schedule II–V per mutually-developed written guidelines; Schedule II prescriptions specifically require supervising-physician review within 96 hours of issuance (243 CMR 2.08(6)). Requires MA Controlled Substance Registration and DEA registration; opioid prescribing must comply with MassPAT (M.G.L. c. 94C).
Written agreement
Required
MA does not require a single freestanding 'supervision agreement' document the way some states do — a PA registers a supervising physician with the Board, and written, mutually-developed 'guidelines' are specifically required for prescriptive practice (243 CMR 2.08(6)). Treated here as agreementRequired=True because prescriptive guidelines are the practical equivalent for any prescribing PA.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Corporation under M.G.L. c. 156A — Massachusetts is widely described as having one of the strictest corporate-practice-of-medicine regimes in the country, generally limiting ownership of a medical practice entity to licensed physicians. Whether PAs have any independent-ownership pathway under c. 156A specifically was not confirmed from primary text in this research pass — treat as unresolved, the same open item VA's file flags for PAs under its own PC/PLLC statutes.
These exceptions are the commonly-cited categories in MA CPOM commentary; not independently re-verified against current statutory text in this pass.
Legal sources for these rules (2)
What a supervising physician costs here
Typical monthly cost in Massachusetts
$500 – $800
Estimate for one Physician Assistant. This state's proximity rules add a small premium.
About Massachusetts's rules
Full practice authority (Acts 2020, c. 260, §36; 244 CMR 4.00) let NPs, PMHNPs, and CNMs practice independently in MA — CNMs immediately, NPs/PMHNPs after a Board-attested transition (244 CMR 4.07). PAs and CRNAs have no independent-practice pathway. MA's professional-corporation ownership rules (M.G.L. c. 156A) are notably strict; this file could not independently re-verify APRN/PA-specific PLLC eligibility this pass — treat CPOM entries as open items.
Other clinicians in Massachusetts: see the state overview.