FREQUENTLY ASKED QUESTIONS FOR PHYSICIAN ASSISTANTS

When do I renew my license?
How much is the renewal fee?
If I do not receive the renewal notice, do I have to pay the renewal fee?
How do I renew my license?
Why am I required to complete Continuing Medical Education (CME) in order to renew my license and when should the CMEs be completed?
Am I required to maintain certification from the National Commission on Certification of Physician Assistants (NCCPA)?
How can I obtain proof that I have renewed my license?
How do I change my address of record?
How do I change my name?
How do I request a license verification?
How do I obtain a new pocket id card or wall certificate if mine was lost, stolen, or destroyed?
Does my supervising physician need approval to supervise me?
How many PAs can a physician supervise?
What documents are required before I can practice?
What is the scope of my practice?
Can I practice independently?
How much supervision must my supervising physician provide?
Is my supervising physician required to be onsite when I am practicing?
Am I allowed to write drug orders?
What information must be on my drug order?
Am I allowed to issue drug orders for controlled substances?
Can I use my supervising physician's DEA number on drug orders for controlled substances?
Is my supervising physician required to sign all of my patient's medical records?
Can I perform surgery?
Can a PA evaluate a patient for the medical use of Marijuana?
Can medical assistants be supervised by a physician assistant in the absence of a physician and surgeon?

1. When do I renew my license?

The Physician Assistant Board administers a birthdate renewal program, which means that all PA licenses expire on the last day of the licensee’s birth month during the second year of a two-year term. Based on this program initial PA licenses may only be valid for as few as thirteen months or as many as twenty-four months. Thereafter, a licensee will be required to renew their license every two years.

A courtesy renewal notice will be mailed to your address of record approximately four months prior to the license expiration date. Please allow six to eight weeks to process renewal applications submitted by mail. Licenses renew instantaneously upon receipt of payment when using the online renewal process.

Licensing details are available online by visiting www.breeze.ca.gov or by calling (916) 561-8780.

2. How much is the renewal fee?

The license renewal fee is $312. Licensees are assessed an annual Controlled Substance Utilization Review and Evaluation System (CURES) fee of $6 annually which is collected at the time of renewal of the license to cover the operation and maintenance of CURES pursuant to Business and Professions Code Section 208. Beginning July 1, 2017, licenses in a retired or inactive status are exempt from the CURES fee. A $25.00 delinquency fee is assessed to the balance due if the renewal payment is not post-marked within thirty days of the license expiration date. If your license is not renewed by the expiration date, you may not legally practice in California.

3. If I do not receive the renewal notice, do I have to pay the renewal fee?

Yes. Failure to receive the renewal notice does not relieve you of your responsibility to renew your license prior to the expiration date. If your license is not renewed by the expiration date, you may not legally practice in California.

4. How do I renew my license?

Renewal options are as follows:

· Renew online by setting up a Breeze account at www.breeze.ca.gov. Online renewals are approved upon submission of payment and a receipt will be provided.

· If using the courtesy renewal notice please be advised processing time may take 6-8 weeks. Courtesy renewal notices are not processed by the Board but by the Department of Consumer Affairs central cashiering. The Board will not be able to track the progress of renewal forms mailed to central cashiering unit.

· Renew by mail by submitting a completed Renewal Application and appropriate fee to the Physician Assistant Board at 2005 Evergreen Street, Suite 1100, Sacramento, CA 95815. Accepted forms of payment include personal checks, money orders, or a cashier’s check made payable to the Physician Assistant Board. A delinquency fee of $25.00 should be included if you are renewing your license thirty days past the license expiration date. Please allow 14 business days to process renewal applications mailed directly to the Physician Assistant Board.

  • In person by visiting the Board at 2005 Evergreen Street, Suite 1100, Sacramento, CA 95815.

5. Why am I required to complete Continuing Medical Education (CME) in order to renew my license and when should the CMEs be completed?

Title 16 of the California Code of Regulations Section 1399.615 mandated by Business and Professions Code Section 3524.5 requires a physician assistant to complete CMEs as a condition of their license renewal, unless you have obtained a waiver from the Board due to health, military service or undue hardship (see Title 16, California Code of Regulations Section 1399.618).

The CME compliance requirement may be met by one of two ways:

Completing 50 Category 1 CME hours through a board approved program as indicated in Title 16 of the California Code of Regulations Section 1399.616, every two years during your renewal cycle.

OR

By being currently certificated by the National Commission on Certification of Physician Assistants (NCCPA) at the time of renewal. For additional CME information, click HERE

6. Am I required to maintain certification from the National Commission on Certification of Physician Assistants (NCCPA)?

No. California does not require that you maintain your national certification in order to renew your physician assistant license. However, licensees who maintain certification from the NCCPA during the renewal cycle may use that certification to satisfy the CME requirement.

For additional CME information, click HERE

7. How can I obtain proof that I have renewed my license?

License details are available online at www.breeze.ca.gov, or by calling (916) 561-8780. You may request a paper verification of your California physician assistant license by mailing a written request and the required $10.00 processing fee to the Physician Assistant Board.at 2005 Evergreen Street, Suite 1100, Sacramento, CA 95815. If more than one license verification is requested please include $10.00 for each request. Checks or money orders should be made payable to the Physician Assistant Board.

8. How do I change my address of record?

Address changes must be submitted to the Board within 30 calendar days after each change (California Code of Regulations Section1399.511). The following options are available to change your address:

· Change your address online by setting up a Breeze account available at https://www.breeze.ca.gov.

· Submit a change of address form to the board by fax, email or mail. The form is available at http://www.pac.ca.gov/forms_pubs/addresschange.pdf.

9. How do I change my name?

Submit, by mail, a completed Name Change Notification, government-issued photographic identification (e.g. driver license, passport, etc.) and legal documentation (copy of marriage certificate, divorce decree, legal name change or naturalization papers). A fee of $10.00 is required when requesting either a new pocket ID card or wall certificate. Checks or money orders should be made payable to the Physician Assistant Board.

10. How do I request a license verification?

You may request a paper verification of your California physician assistant license by mailing a written request and the required $10.00 processing fee to the Physician Assistant Board at 2005 Evergreen Street, Suite 1100, Sacramento, CA 95815. If more than one license verification is requested, please include $10.00 for each request. Checks or money orders should be made payable to the Physician Assistant Board.

11. How do I obtain a new pocket id card or wall certificate if mine was lost, stolen, or destroyed?

Mail the completed Duplicate License Request form and appropriate fees to the Physician Assistant Board at 2005 Evergreen Street, Suite 1100, Sacramento, CA 95815. Checks or money orders should be made payable to the Physician Assistant Board.

12. Does my supervising physician need approval to supervise me?

No. Business and Professions Code Section 3502 provides that a physician assistant licensed by the Board may perform medical services under the supervision of a physician and surgeon who is not subject to a disciplinary condition imposed by the Medical Board of California prohibiting that employment or supervision.

13. How many PAs can a physician supervise?

Current law limits a physician to supervising no more than four PAs at any one time.

14. What documents are required before I can practice?

Title 16 of the California Code of Regulations section 1399.540 requires the supervising physician to delegate in writing those medical services that the PA is competent to perform and are consistent with the PAs education, training and experience. The document that delegates the medical services is a Delegation of Services Agreement (DSA).

Medical services must be consistent with the supervising physician's specialty or usual and customary practice and with the patient's health. The agreement must be completed and signed before you start practicing. You do not need to submit the DSA to the Board.

You can obtain the sample DSA agreement by visiting http://www.pac.ca.gov/forms_pubs/delegation.doc or by calling (916) 561-8780.

15. What is the scope of my practice?

Because a physician assistant acts as an agent for a supervising physician the scope of practice is limited by his/her supervising physician’s specialty. The Delegation of Services Agreement between you and your supervising physician further defines exactly what tasks and procedures are being delegated. These tasks and procedures must be consistent with your supervising physician's specialty or usual and customary practice and with the patient's health and condition.

Before authorizing a PA to perform any medical procedure, the physician is responsible for evaluating the PA’s education, experience, knowledge, and ability to perform the procedure safely and competently.

A PA may NOT perform any of the following medical services pursuant to Business and Professions Code section 3502 (d):

  • The determination of the refractive states of the human eye, or the fitting or adaptation of lenses or frames.
  • The prescribing or directing the use of, or using any optical device in connection with ocular exercises, visual training or orthoptics.
  • The prescribing, fitting or adaptation of contact lenses.
  • The practice of dentistry or dental hygiene or the work of a dental auxiliary.

A PA may perform a routine visual screening defined pursuant to Business and Professions Code section 3501 (a)(8) as an uninvasive nonpharmacological simple testing for visual acuity, visual field defects, color blindness, and depth perception.

Additional information regarding scope of practice and supervision can be found in Business and Professions Code Section 3502 and, Title 16, California Code of Regulations sections 1399.540 through 1399.546 .

16. Can I practice independently?

No, you cannot practice independently. Every PA must be supervised by a licensed physician (either M.D. or D.O.). The supervising physician is responsible for all medical services provided by a PA under his/her supervision and for following each patient's progress.

17. How much supervision must my supervising physician provide?

A physician assistant and his or her supervising physician shall establish in writing guidelines for the adequate supervision of the physician assistant which shall include:

(1) one of the supervision mechanisms authorized by Section 3502.1 of the Business and Professions Code if the physician assistant has been delegated authority to administer, provide or issue a drug order to a patient for Schedule II controlled substances, and

(2) one or more of the following mechanisms:

(A) Examination of the patient by a supervising physician the same day as care is given by the physician assistant;

(B) Countersignature and dating of all medical records written by the physician assistant within thirty (30) days that the care was given by the physician assistant;

(C) Any mechanism authorized by Section 3502 of the Business and Professions Code; or,

(D) Other mechanisms approved in advance and in writing by the board.

The supervising physician has continuing responsibility to follow the progress of the patient and to make sure that the physician assistant does not function autonomously. The supervising physician shall be responsible for all medical services provided by a physician assistant under his or her supervision.

18. Is my supervising physician required to be onsite when I am practicing?

No, your supervising physician is not required to be on site but must be available in person or by electronic communication at all times when you are caring for patients.

19. Am I allowed to write drug orders?

Yes. Business and Professions Code section 3502.1 authorizes PAs to administer or provide medication to a patient, or transmit orally, or in writing on a patient’s record or in a drug order, an order to a person who may lawfully furnish the medication. The supervising physician must authorize that authority to you in the delegation of services agreement. When issuing a drug order, you are acting on behalf of and as an agent for your supervising physician.

Before you can issue drug orders, your supervising physician must first prepare and adopt a written, practice specific, formulary and protocols that specify all criteria for the use of a particular drug or device and any contraindications. The drugs listed constitute the formulary and may only include drugs that are appropriate for use in the practice.

Any variations require advance approval from your supervising physician for the particular patient before issuing a drug order.

You may not issue a drug order to a patient for Schedule II through V controlled substances without advance approval by your supervising physician for a particular patient unless you have completed a specified controlled substance course. See question number 22.

20. What information must be on my drug order?

Business and Professions Code section 3502.1 (d) requires that a PA's written drug order contain the printed name, address, and phone number of the supervising physician, and the signature, printed or stamped name, and license number of the PA. If the drug order is for a controlled substance, it must also include your DEA number.

21. Am I allowed to issue drug orders for controlled substances?

Yes, you must register with the United States Drug Enforcement Administration (DEA) and obtain a DEA number before issuing drug orders for Schedule II through V controlled substances if your supervising physician delegates that authority to you. However, you may not administer, provide or issue a drug order for Schedule II through V controlled substances, including refills, without advance approval by your supervising physician for the particular patient. The medical record of any patient for a Schedule II drug order must be reviewed, countersigned, and dated by your supervising physician within 7 days.

If you have documentation of the successful completion of a controlled substance education course that meets the criteria established by the Board in Title 16, California Code of Regulations Section 1399.610, the patient specific advance approval is no longer required. The supervising physician and surgeon shall review, countersign, and date, within seven days, a sample consisting of the medical records of at least 20 percent of the patients cared for by the PA for whom the PA’s schedule II drug order has been issued or carried out.

22. Can I use my supervising physician's DEA number on drug orders for controlled substances?

No, PAs that are authorized by their supervising physician to issue drug orders for controlled substances must register with the United States Drug Enforcement Administration (DEA) and obtain their own DEA number.

23. Is my supervising physician required to sign all of my patient's medical records?

Business and Professions Code section 3502 states that the supervising physician and surgeon shall use one or more of the following mechanisms to ensure adequate supervision of the physician assistant functioning under the protocols adopted by the supervising physician and physician assistant:

· The supervising physician and surgeon shall review, countersign, and date a sample consisting of, at a minimum, 5 percent of the medical records of patients treated by the physician assistant functioning under the protocols within 30 days of the date of treatment by the physician assistant

· The supervising physician and surgeon and physician assistant shall conduct a medical records review meeting at least once a month during at least 10 months of the year. During any month in which a medical records review meeting occurs, the supervising physician and surgeon and physician assistant shall review an aggregate of at least 10 medical records of patients treated by the physician assistant functioning under protocols. Documentation of medical records reviewed during the month shall be jointly signed and dated by the supervising physician and surgeon and the physician assistant.

· The supervising physician and surgeon shall review a sample of at least 10 medical records per month, at least 10 months during the year, using a combination of the countersignature mechanism described in clause (i) and the medical records review meeting mechanism described in clause (ii). During each month for which a sample is reviewed, at least one of the medical records in the sample shall be reviewed using the mechanism described in clause (i) and at least one of the medical records in the sample shall be reviewed using the mechanism described in clause (ii).

While using any of these supervision mechanisms, the supervising physician and surgeon shall select for review those cases that by diagnosis, problem, treatment, or procedure represent, in his or her judgment, the most significant risk to the patient.

The Medical Board of California or the board may establish other alternative mechanisms for the adequate supervision of the PA (see Title 16, California Code of Regulations, Section 1399.545.)

24. Can I perform surgery?

Title 16, California Code of Regulations Section 1399.541 indicates the following:

· Perform surgical procedures without the personal presence of the supervising physician which are customarily performed under local anesthesia. Prior to delegating any such surgical procedures, the supervising physician shall review documentation which indicates that the physician assistant is trained to perform the surgical procedures. All other surgical procedures requiring other forms of anesthesia may be performed by a physician assistant only in the personal presence of an supervising physician.

· A physician assistant may also act as first or second assistant in surgery under the supervision of a supervising physician. The physician assistant may so act without the personal presence of the supervising physician if the supervising physician is immediately available to the physician assistant. “Immediately available” means the physician is physically accessible and able to return to the patient, without any delay, upon the request of the physician assistant to address any situation requiring the supervising physician's services.

25. Can a PA evaluate a patient for the medical use of Marijuana?

A physician assistant has limited responsibilities with regard to the recommendation for medical marijuana. A physician assistant may evaluate a patient consistent with the physician assistant's Delegation of Services Agreement and protocol, if applicable. However, only an attending physician is authorized to recommend medical use of marijuana pursuant to Health and Safety Code section 11362.5.

For additional information about Medical Marijuana Program, please visit the Department of Public Health website at: https://www.cdph.ca.gov/Programs/CHSI/Pages/Medial-Marijuana-Identification-Card.aspx .

For additional information for physicians who wish to recommend medical marijuana as part of their regular practice of medicine please visit the Medical Board of California's website at: https://www.mbc.ca.gov/Publications/guidelines_cannabis_recommendation.pdf .

26. Can medical assistants be supervised by a physician assistant in the absence of a physician and surgeon?

Under the provisions of Business and Professions Code 2069(a)(1), a medical assistant may administer medication only by intradermal, subcutaneous, or intramuscular injections and perform skin tests and additional technical supportive services upon the specific authorization and supervision of a licensed physician and surgeon or a licensed podiatrist. A medical assistant may also perform all these tasks and services upon the specific authorization of a physician assistant, a nurse practitioner, or a certified nurse-midwife. However, supervision of a medical assistant for the above mentioned tasks and supportive services may be delegated to the physician assistant under newly enacted provision locate at Section 2069(a)(2) of the Business and Professions Code, which states:

The supervising physician and surgeon may, at his or her discretion, in consultation with the nurse practitioner, certified nurse-midwife, or physician assistant, provide written instructions to be followed by a medical assistant in the performance of tasks or supportive services. These written instructions may provide that the supervisory function for the medical assistant for these tasks or supportive services may be delegated to the nurse practitioner, certified nurse-midwife, or physician assistant within the standardized procedures or protocol, and that tasks may be performed when the supervising physician and surgeon is not onsite, if either of the following apply:

  • The nurse practitioner or certified nurse-midwife is functioning pursuant to standardized procedures, as defined by Section 2725, or protocol. The standardized procedures or protocol, including instructions for specific authorizations, shall be developed and approved by the supervising physician and surgeon and the nurse practitioner or certified nurse-midwife.
  • The physician assistant is functioning pursuant to regulated services defined in Section 3502, including instructions for specific authorizations, and is approved to do so by the supervising physician and surgeon.

Additionally, Business and Professions Code Section 2069(b)(3) states that, “Supervision” means the supervision of procedures authorized by this section by the following practitioners, within the scope of their respective practices, who shall be physically present in the treatment facility during the performance of those procedures:

  • A licensed physician and surgeon
  • A licensed podiatrist
  • A physician assistant, nurse practitioner, or certified nurse-midwife

Business and Professions Code Section 2069(b)(2) states, “Specific authorization” means a specific written order prepared by the supervising physician and surgeon or the supervising podiatrist, or the physician assistant, the nurse practitioner, or the certified nurse-midwife as provided in subdivision (a), authorizing the procedures to be performed on a patient, which shall be placed in the patient’s medical records, or a standing order prepared by the supervising physician and surgeon or the supervising podiatrist, or the physician assistant, the nurse practitioner, or the certified nurse-midwife as provided in subdivision (a), authorizing the procedures to be performed, the duration of which shall be consistent with accepted medical practice. A notation of the standing order shall be placed on the patient’s medical record.

For further information concerning medical assistants, visit the Medical Board of California's website at: http://www.mbc.ca.gov/licensees/physicians_and_surgeons/medical_assistants

Revision 3/2018