Section 422.13 - Physician Assistants(a)Authorized services.--A physician assistant may perform a medical service delegated by an approved physician and as approved by the appropriate board. An approved physician is a physician identified in the written agreement required by subsection (e).(b)Use of title.--A physician assistant may use the title physician assistant or an appropriate abbreviation for that title, such as "P.A.-C."(c)Regulations.--The board shall promulgate regulations which define the services and circumstances under which a physician assistant may perform a medical service.(c.1) Except as limited by subsection (c.2), and in addition to existing authority, a physician assistant shall have authority to do all of the following, provided that the physician assistant is acting within the supervision of the supervising physician:(1) Order durable medical equipment.(2) Issue oral orders to the extent permitted by a health care facility's bylaws, rules, regulations or administrative policies and guidelines.(3) Order physical therapy and dietitian referrals.(4) Order respiratory and occupational therapy referrals.(5) Perform disability assessments for the program providing Temporary Assistance to Needy Families (TANF).(6) Issue homebound schooling certifications.(7) Perform and sign the initial assessment of methadone treatment evaluations in accordance with Federal and State law and regulations, provided that any order for methadone treatment shall be made only by a physician.(c.2) Nothing in this section shall be construed to:(1) Supersede the authority of the Department of Health and the Department of Human Services to regulate the types of health care professionals who are eligible for medical staff membership or clinical privileges.(2) Restrict the authority of a health care facility to determine the scope of practice and supervision or other oversight requirements for health care professionals practicing within the facility.(d)Supervision.-- The supervising physician shall be responsible for the medical services that a physician assistant renders. Supervision shall not require the onsite presence or personal direction of the supervising physician.(d.1)Patient record review.--(1), (2) Deleted by 2021, Oct. 7, P.L. 418, No. 79, § 3, imd. effective.(3) The primary supervising physician shall determine countersignature requirements of patient records completed by the physician assistant in a written agreement, except as provided for in paragraph (4).(4) The primary supervising physician shall countersign 100% of patient records completed by the physician assistant within a reasonable time, which shall not exceed ten days, during each of the following time periods:(i) The first 12 months of the physician assistant's practice post graduation and after the physician assistant has fulfilled the criteria for licensure set forth in section 36(c).(ii) The first 12 months of the physician assistant's practice in a new specialty in which the physician assistant is practicing.(5) The board may not require, by order, regulation or any other method, countersignature requirements of patient records completed by a physician assistant that exceed the requirements specified under this subsection.(e)Written agreement.--A physician assistant shall provide medical services according to a written agreement which provides for all of the following: (1) Identifies and is signed by the primary supervising physician.(2) Describes the physician assistant's scope of practice.(3) Describes the nature and degree of supervision the primary supervising physician will provide the physician assistant.(4) Is prepared and submitted by the primary supervising physician, the physician assistant or a delegate of the primary supervising physician and the physician assistant. It shall not be a defense in any administrative or civil action that the physician assistant acted outside the scope of the board-filed description or that the supervising physician utilized the physician assistant outside the scope of the board-filed description because the supervising physician or physician assistant permitted another person to represent to the board that the description had been approved by the supervising physician or physician assistant.(5) Deleted by 2021, Oct. 7, P.L. 418, No. 79, § 3, imd. effective.(6) Becomes effective upon submission by the primary supervising physician, the physician assistant or a delegate of the primary supervising physician and the physician assistant to the board. The board shall review 10% of all written agreements submitted to the board after the effective date of this paragraph. A written agreement subject to a review shall remain in effect for two weeks after the board notifies the primary supervising physician and the physician assistant with remedies, if necessary, on the outcome of the review. The primary supervising physician, physician assistant or delegate to the primary supervising physician and physician assistant must submit a new written agreement which shall be effective upon submission to the board. A written agreement submitted to the board during the declaration of disaster emergency issued by the Governor on March 6, 2020, published at 50 Pa.B. 1644 (March 21, 2020), or any renewal of the declaration of disaster emergency, shall be deemed approved. This paragraph shall apply to written agreements submitted to the board before the effective date of this paragraph.(7) No later than 120 days from the effective date of this paragraph, the board shall submit the review process for the written agreements under paragraph (6) to the Legislative Reference Bureau for publication in the Pennsylvania Bulletin. A physician assistant shall not assist a physician in a manner not described in the agreement or without the nature and degree of supervision described in the agreement. There shall be no more than six physician assistants for whom a physician has responsibility or supervises pursuant to a written agreement at any time. In health care facilities licensed under the act of July 19, 1979 (P.L. 130, No. 48), known as the Health Care Facilities Act, a physician assistant shall be under the supervision of a physician or physician group pursuant to a written agreement, provided that a physician supervises no more than six physician assistants at any time. A physician may apply for a waiver to employ or supervise more physician assistants at any time under this section for good cause, as determined by the board.
(f)Drugs.--A physician assistant shall not independently prescribe or dispense drugs. The board shall promulgate regulations which permit a physician assistant to prescribe and dispense drugs at the direction of a physician. The board shall request the comments and recommendations of the State Board of Pharmacy.(g)Supervision.--A physician assistant may be employed by a health care facility licensed under the Health Care Facilities Act under the supervision of an approved physician or group of such physicians, provided one of those physicians is designated as having the primary responsibility for supervising the physician assistant. In health care facilities licensed under the Health Care Facilities Act, the attending physician of record for a particular patient shall act as the primary supervising physician for the physician assistant while that patient is under the care of the attending physician. Nothing in this act shall be construed to authorize an employer or other entity to require a physician to supervise more physician assistants when the physician, in his or her clinical judgment, determines that supervising more physician assistants will compromise patient care or otherwise affect the physician's ability to properly supervise another physician assistant in accordance with the requirements of this act or regulations promulgated by the board.(h)Reimbursement.--For reimbursement purposes, a physician assistant shall be an employee subject to the normal employer-employee reimbursement procedures.(i)Eye services.--No medical services may be performed by a physician assistant under this act which include the measurement of the range or powers of human vision or the determination of the refractive status of the human eye. This subsection does not prohibit the performance of routine vision screenings or the performance of refractive screenings in the physician's office.(j)Chiropractic practice.--Nothing in this act shall be construed to allow physician assistants to practice chiropractic.(k)Other licenses or certificates.--Nothing in this section or the regulations authorized by this section shall be construed to prohibit a physician assistant who is licensed or certified to practice another profession by a Commonwealth agency or board from practicing within the scope of that license or certificate or as otherwise authorized by law.Amended by P.L. 418 2021 No. 79, § 3, eff. 10/7/2021.Amended by P.L. TBD 2019 No. 68, § 2, eff. 8/1/2019.Amended by P.L. 1143 2013 No. 100, § 1, eff. 1/26/2014.1985, Dec. 20, P.L. 457, No. 112, §13, effective Jan. 1, 1986. Amended 2007 , July 20, P.L. 314, No. 46, § 1, effective in 60 days [Sept. 18, 2007]; 2008, July 4, P.L. 580, No. 45, § 4, effective in 60 days [Sept. 2, 2008].