Physician Assistant Cheat Sheet for Maryland

Requirements for Supervising Physician agreements in Maryland, plus a free agreement builder tailored to Maryland law.

Provider supervision requirements in Maryland

Updated 2026-09-03

Provided for educational and research purposes only — this is not legal advice. Laws and regulations change frequently, and this content may contain errors or omissions. Always confirm current requirements with a licensed attorney before relying on this for compliance decisions.

Maryland's APRN categories are not uniform: CRNPs and CNMs gained full practice authority in 2015 (after an 18-month new-graduate mentorship), CRNAs remain fully supervised with no prescriptive authority at all (Maryland is one of about 11 states granting CRNAs none), and only the psychiatric-mental-health population focus of CNS practice is independent. Maryland does not recognize PLLCs; professional entities use physician-only professional corporations, so multi-disciplinary ownership questions remain open.

Physician Assistant

Supervision required

No independent-practice or experience-based autonomy pathway exists for PAs in Maryland — a delegation agreement with a supervising physician and 'continuous supervision' are required for as long as the PA practices (Health Occ. § 15-302; COMAR 10.32.03).


Proximity

Available remotely (no on-site requirement)

COMAR 10.32.03.05 requires the delegation agreement to describe 'continuous physician supervision mechanisms reasonable and appropriate to the practice setting' and the physician to attest to responding to the PA 'in a timely manner'; there is no on-site or mile or minute radius standard.

Chart review

Not codified — left to the practice agreement

Prescriptive authority

Separate prescribing terms required · controlled substances permitted

Schedule II-III: 30-day supply max per single filling (7-day max for institutionalized patients' Schedule II). A patient-care-team physician may delegate prescribing/dispensing of Schedules II-V, provided the PA holds both a Maryland CDS registration and a federal DEA registration; the delegation agreement must attest to compliance with applicable state/federal law. PAs may not delegate dispensing of drug samples/starter dosages.

Practice ownership (CPOM)

Licensee-only ownership required — Professional corporation; Maryland does not recognize PLLCs, and medical-services PCs are described as issuing stock only to licensed physicians (secondary summary)

This ownership question is legally distinct from the clinical delegation agreement above.

Supervision ratio

Up to 4 at a time

A primary (or alternate) supervising physician may not supervise more than 4 PAs at any one time, except in hospitals, correctional/detention facilities, or public health facilities, where this cap does not apply (COMAR 10.32.03.07).

Meeting cadence

Not codified — left to the practice agreement

Written agreement

Required

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