The AMA has posted a Scope of practice on PA's and states Co signature – 20 states require a certain percentage or number of PA charts to be co-signed by a physician.
Because state laws and regulations differ for each state, non-physician practitioners are encouraged to review their state laws governing their specialty, as well as state and national professional association regulations. A supervising physician counter-signature is required after a nurse practitioner documentation/signature
that work incident to a supervising physician. Refer to incident-to guidelines in the Medicare Benefit Policy Manual - Chapter 15; section 60 - Incident To:
For Example, Calfornia Law states:
“Adequate supervision of a PA” must include one or more of the following:
1. The supervising physician must review, countersign, and date a sample of at least 5 percent (5%) of the medical records of patients treated by the PA within thirty days of the date of the PA’s treatment.