Section 5.03 - Scope of Services Which May Be Performed(1) A physician assistant may, under the supervision of a licensed physician, perform any and all services which are: (a) Within the competence of the physician assistant in question, as determined by the supervising physician's assessment of his or her training and experience; and(b) Within the scope of services for which the supervising physician can provide adequate supervision to ensure that accepted standards of medical practice are followed.(2) A physician assistant may approach patients of all ages and with all types of conditions; elicit histories; perform examinations; order, perform and interpret diagnostic studies; order and perform therapeutic procedures; instruct and counsel patients regarding physical and mental health issues; respond to life-threatening situations; and facilitate the appropriate referral of patients; consistent with his or her supervising physician's scope of expertise and responsibility and the level of authority and responsibility delegated to him or her by the supervising physician.(3) Nothing contained in 263 CMR 5.00 shall be construed to allow a physician assistant to: (a) give general anesthesia;(b) perform any procedure involving ionizing radiation, except:1. in an emergency situation where the procedure is performed under the direction and control of a licensed physician; or2. where authorized to operate fluoroscopic x-ray systems pursuant to 105 CMR 120.405(K): Operator Qualifications and in compliance with 263 CMR 5.08 and 243 CMR 2.08(6): Physician Assistants Authorized to Operate Fluoroscopic X-ray Systems; or(c) render a formal medical opinion on procedures involving ionizing radiation.(4) Where a physician assistant is involved in the performance of major invasive procedures, such procedures shall be undertaken under specific written protocols, available to the Board upon request, which have been developed between the supervising physician and the physician assistant and which specify, among other things the level of supervision the service requires, e.g., direct (physician in room), personal (physician in building), or general (physician available by telephone).Amended by Mass Register Issue 1335, eff. 3/24/2017.