PA · District of Columbia
Collaborative Drug Therapy Management for Physician Assistants in District of Columbia
Yes, a written agreement with a physician is required before you prescribe and adjust drug therapy. District of Columbia calls it a Delegation Agreement.
DC has not adopted an experience-based autonomous-practice pathway for PAs (unlike, for example, Virginia's 2026 reform or North Dakota). A PA in DC needs an active Delegation Agreement with a supervising physician for as long as they practice.
What the physician relationship 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)
17 DCMR § 4914 requires the PA to be under physician supervision at all times while practicing; the regulation does not set an on-site requirement or a mile or minute radius.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Quarterly
The PA and a supervising physician listed on the Delegation Agreement must complete a documented 'Practice Advisory Review' quarterly, kept in the PA's personnel file at the practice site (DC Health Delegation Agreement form; D.C. Code § 3-1204 framework).
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
The Delegation Agreement must address the PA's delegated prescriptive authority. Controlled-substance prescribing requires the supervising physician to delegate that authority and the PA to hold a DC controlled-substance registration plus DEA registration. The regulation does not spell out schedule-level limits; do not assume unrestricted Schedule II authority without checking the current Delegation Agreement form and 17 DCMR.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation or PLLC under D.C. Code § 29-508 (physician-owned; shares transferable only to physicians or the corporation)
This ownership question is distinct from the Delegation Agreement below, which governs clinical oversight of the PA, not who may own the entity the PA practices through.
Sources for the supervision rules (5)
- D.C. Code § 3-1204 — Board of Medicine authority over PA delegation agreements
- 17 DCMR § 4914 — Supervision (Physician Assistants)
- 17 DCMR § 4911 — Scope of Practice (Physician Assistants)
- DC Health — Physician Assistant Delegation Agreement form
- D.C. Code § 29-508 — Professional corporation ownership requirements (secondary-sourced summary)secondary
What a collaborating physician costs here
Typical monthly cost in District of Columbia
$500 – $700
Estimate for one Physician Assistant. This state's proximity rules add a small premium.
About District of Columbia's rules
The Health Occupations Revision Amendment Act of 2024 repealed D.C. Code § 3-1206.03, removing the collaboration mandate for every APRN category (NP, PMHNP, CRNA, CNM, CNS); DC is now a full-practice-authority jurisdiction for APRNs. PAs are not covered by that reform and still need a Board of Medicine Delegation Agreement regardless of experience.
Other clinicians in District of Columbia: see the state overview.