Supervision Watch · 2026-W36
Two PAs per physician: Kansas and Puerto Rico hold the tightest caps on file
A quiet week — no research changes and no state bill feeds — so we put the ratio caps side by side. Six jurisdictions limit one physician to four PAs or fewer.
Strictest and loosest this week
28 jurisdictions cap how many physician assistants one physician may supervise or collaborate with; these are the lowest caps on file.
Kansas: 2 PAs per physician
Kansas holds the tightest cap in our matrix: a physician may supervise or collaborate with no more than two physician assistants. For a PA weighing a second per-diem site, the cap is the physician's constraint, not yours — but it decides whether the agreement can be signed at all.
Puerto Rico: 2 PAs per physician
Puerto Rico matches Kansas at two physician assistants per physician, the lowest cap among the 28 jurisdictions that set one.
Arkansas: 3 PAs per physician
Arkansas caps a supervising physician at three physician assistants.
Nevada: 3 per physician, counted across provider types
Nevada's cap is three, and it is combined across provider types — advanced practice nurses on the same physician's roster count against the same number a PA needs room in.
Wyoming: 3 PAs per physician
Wyoming sets the limit at three physician assistants per physician.
Alaska: 4 PAs per physician
Alaska rounds out the tightest six at four physician assistants per physician.
Where ratio caps sit in the wider PA picture
Ratio caps travel with the other terms of a supervision agreement — proximity, chart review, and whether a separate prescriptive agreement is required. The all-states PA view lists them together.
Moved in our research
Nothing changed in the matrix this week.
No status or agreement-term changes recorded for PAs or NPs
Our research log is empty for the week ending 2026-09-05: no ratio, proximity, filing or prescriptive-agreement terms changed, and no state moved on the PA collaboration relabeling. Separately, no LegiScan or Open States key was configured this run, so state bill activity was not searched — treat the absence of bills below as a gap in our retrieval, not as quiet statehouses.
Every outside claim carries the source it was read from this week. Our own research dates are on each state page. Published 2026-09-05.