PA · Tennessee
Collaborative Drug Therapy Management for Physician Assistants in Tennessee
Yes, a written agreement with a physician is required before you prescribe and adjust drug therapy. Tennessee calls it a Supervisory Practice Agreement.
PAs have no independent-practice pathway. The Board of Medical Examiners regulates PA supervision under a structure parallel to the NP collaboration rules; the chart-review and site-visit figures below follow that parallel NP framework and should be confirmed against the PA chapter.
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
On-site presence required
Follows Tennessee's parallel APRN rule requiring the collaborating or supervising physician to make an in-person visit to a remote practice site every 30 days (up to 10 of the required annual visits may occur via HIPAA-compliant telehealth); confirm against Tenn. Comp. R. & Regs. Ch. 1130-01 that the same cadence applies to PA supervision.
Supervision ratio
Not codified — no cap on file
Chart review
20% of charts · Monthly · countersignature required
Follows Tennessee's parallel APRN chart-review rule (the physician must personally review at least 20% of charts every 30 days, plus 100% of controlled-substance charts, with additional review every 10 business days under specified trigger conditions); confirm against Tenn. Comp. R. & Regs. Ch. 1130-01 that it applies identically to PA supervision.
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Secondary sources disagree on whether the range is Schedule II–V or II–IV; confirm current scope with the Board before relying on this for a specific prescription.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation or PLLC 100% owned by physicians licensed in Tennessee; a professional corporation may practise only a single profession, so a PA cannot co-own the PC even alongside physicians
Violating TN's Practice of Medicine statute (TCA § 63-6-204) is a Class B misdemeanor.
Sources for the supervision rules (3)
- Tenn. Code Ann. § 63-6-204 — Practice of Medicine Act (corporate practice of medicine)
- Tenn. Comp. R. & Regs. Ch. 1130-01 — General Rules Governing the Practice of a Physician Assistantsecondary
- Permit Health — Tennessee Corporate Practice of Medicine (CPOM) Guidesecondary
What a collaborating physician costs here
Typical monthly cost in Tennessee
$600 – $900
Estimate for one Physician Assistant. This state's rules add a restrictive-tier premium.
About Tennessee's rules
TN is a restricted-practice state for NPs — no independence pathway exists. Physicians must personally review ≥20% of an APRN's charts every 30 days (100% of controlled-substance charts) and visit remote practice sites in person every 30 days. TN has an explicit, unambiguous corporate-practice-of-medicine ban (statute, case law, and AG opinions; TCA § 63-6-204) — a professional corporation may practice only a single profession.
Other clinicians in Tennessee: see the state overview.