PA · Oklahoma
Collaborative Drug Therapy Management for Physician Assistants in Oklahoma
Yes, a written agreement with a physician is required before you prescribe and adjust drug therapy. Oklahoma calls it a Written Practice Agreement.
Before H.B. 2584, PAs had no independent-practice pathway in Oklahoma at all. The reform 'permits experienced PAs to practice without a formal supervising physician when they meet statutory criteria and maintain appropriate collaborative relationships and professional liability coverage'; the specific threshold should be confirmed with the Board.
Independent practice requires: Experience-based threshold created by H.B. 2584 (2025, eff. Nov. 1, 2025); the hour or year figure and application criteria are set by the Board of Medical Licensure and Supervision.
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
PA below the H.B. 2584 independence threshold: Available remotely (no on-site requirement)
No geographic/proximity requirement is codified; the supervising physician need not even be physically located in Oklahoma. Availability standard is 'direct contact, telecommunications, or other appropriate electronic means for consultation, assistance with medical emergencies, patient referral.'
Supervision ratio
PA below the H.B. 2584 independence threshold: Up to 6 at a time (combined across provider types)
OAC 435:10-13-2 caps a supervising physician at 6 PAs and NPs combined, waivable by the Board on request. One secondary source describes this cap as still in force after the H.B. 2298 and H.B. 2584 reforms; another describes post-reform Tier 1 (supervised) APRNs as having no ratio cap. Confirm the cap's continued applicability against the current rule text.
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Schedule I and II controlled substances are excluded by the statutory exclusionary formulary (63 O.S. § 2-312(C)); Schedule III–V limited to a 30-day supply, including time-released formulations. Requires federal DEA and Oklahoma Bureau of Narcotics and Dangerous Drugs (OBNDD) registration.
Written agreement
Required
Required for PAs below the H.B. 2584 independence threshold (unconfirmed exact figure); not required once independent status is granted.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — Oklahoma has no corporate-practice-of-medicine doctrine and no statute specifically restricting CPOM — the state's Professional Corporation Act does not bar non-physician (including PA) ownership of a medical entity the way many CPOM states do (Okla. Att'y Gen. Op. 77-168, Aug. 29, 1977).
Secondary-sourced (compliance-guide) characterization of a 1977 A.G. opinion and the absence of a modern CPOM statute — worth confirming nothing has changed since, given how old the opinion is.
Sources for the supervision rules (5)
- Oklahoma House Bill 2584 (2025, eff. Nov. 1, 2025) — PA independence pathway
- Okla. Admin. Code § 435:10-13-2 — Physician Ratio Limits (pre-reform; post-reform continued applicability unconfirmed)
- Okla. Stat. tit. 63, § 2-312(C) — Exclusionary Formulary (Schedule I–II prohibition)
- Okla. Att'y Gen. Op. No. 77-168 (Aug. 29, 1977) — No CPOM doctrine
- CollaboratingPhysician.com — Oklahoma Collaborating Physician Requirements & Compliance Rules (2026 Guide) (secondary source on H.B. 2298/2584 reform)secondary
What a collaborating physician costs here
Typical monthly cost in Oklahoma
$500 – $600
Estimate for one Physician Assistant. This state's proximity rules add a small premium.
About Oklahoma's rules
HB 2298 (APRNs) and HB 2584 (PAs), both 2025 and effective Nov. 1, 2025, created new hours-based independent-practice pathways in a state with no prior pathway for either. Being this recent, secondary sources conflict on whether a 6-provider physician-ratio cap (OAC 435:10-13-2) still applies post-reform — flagged per-provider below rather than guessed. Oklahoma has no corporate-practice-of-medicine doctrine (Okla. A.G. Op. 77-168).
Other clinicians in Oklahoma: see the state overview.