Summary
NCMB is currently engaged in the rule-making process of the team-based practice provision (see: 21 NCAC 32S .0227) and will provide more information upon the adoption of rules; this provision does not go into effect until NCMB adopts rules or June 30, 2026, whichever occurs first.
Part VI of SL 2025-37 establishes a team-based practice physician assistant. Team-based practice physician assistants must practice in team-based settings, which include certain health care facilities and certain physician-owned medical practices. They must have more than 4,000 hours of clinical practice experience as a licensed physician assistant and more than 1,000 hours of clinical experience within their medical specialty. Physician assistants must apply to NCMB for team-based status. Approved team-based physicians assistants are not required to file an intent to practice with NCMB, however, team-based physician assistants are still expected to collaborate and consult with other members of the health care team as necessary. See the requirements listed here.
FAQs
- No. Team-based practice is only available to physician assistants that meet all of the following:
- More than 4,000 hours of clinical practice experience as a physician assistant AND more than 1,000 hours of clinical practice experience within the specific medical specialty of practice with a physician in that specialty.
- Practices at a team-based setting or team-based practice.
- Physician assistants, who are not eligible for team-based practice, must practice in accordance with all current NCMB rules pertaining to supervision.
No. Team-based practice is not mandatory and whether you can be hired as a team-based physician assistant is up to your employer. If team-based practice is not adopted, then you must follow all current NCMB rules pertaining to supervision.
Yes. In order to submit your registration, you must confirm that your practice or facility has chosen to engage in team-based practice and that you have been hired or promoted to practice as a team-based physician assistant.
A team-based setting or team-based practice must be either:
- A medical practice that meets all of the following:
- The majority of the practice is owned collectively by one or more licensed physicians.
- An owner who (1) is an NC licensed physician and (2) has consistent and meaningful participation in the design and implementation of health services to patients.
- The physician and team-based physician assistant that provide services at the medical practice must work in the same clinical practice area.
- A hospital, clinic, nursing home, or other health facility with active credentialing and quality programs where physicians have consistent and meaningful participation in the design and implementation of health services to patients.
- PAs who are registered as team-based practice PAs do not need to file an intent to practice or have a supervisory arrangement with a physician. However, team-based practice physician assistants must work in team-based settings alongside licensed physicians who have consistent and meaningful participation in the practice. Physician assistants are required to consult, collaborate and refer with physicians as determined by the team.
- In addition, team-based practice physician assistants are limited to practicing in their registered team-based setting and designated area of practice. If their employment or area of practice changes, they must either file an intent to practice or register with the NCMB if the setting qualifies as a team-based practice.
- While NC laws and rules do not require team-based physician assistants to have supervising physicians, the law does not restrict or limit an employer’s ability impose additional requirements on employees, including supervision. Whether a physician assistant is hired or promoted as a team-based physician assistant is up to the employer. When employers choose not to participate in team-based practice, all physician assistants must comply with current supervision requirements under NCMB rules.
- Physician assistants, who are not eligible for team-based practice, must practice in accordance with all current NCMB rules pertaining to supervision.
Yes. Any PA who is eligible for team-based practice and working in an appropriate team-based setting is required to submit proof to the NCMB of team-based practice qualifications. Physician assistants cannot commence practice as a team-based practice until they receive authorization from the NCMB. The process is still being developed. More details will be available when rules are finalized. Until a physician assistant is registered as a team-based physician assistant with the NCMB, all supervision requirements under NCMB’s current rules must be satisfied.
Register by visiting http://www.ncmedboard.org and logging in to the Licensure Gateway. Find the registration link on the main page next to links related to Intent to Practice. Complete and submit the form.
Physician assistants must provide their team-based practice address, identify their team-based practice specialty, attest that they meet all the requirements for team-based practice, and acknowledge that they understand any limitations as required by the law.
There is no notarization requirement or requirement to upload any supporting documentation.
Registering for team-based practice does not nullify any current intent to practice forms filed with NCMB. If a PA will no longer practice in any settings where a primary supervising physician is required, the PA will need to update their intent to practice form. To update this information, login to the Licensure Gateway, navigate to the Intent to Practice form and remove any sites or supervisors that are no longer applicable.
Yes.
- Physician assistants working in perioperative settings will need to be supervised by a physician as determined by NCMB rules. More details will be available in the Spring.
- Physician assistants cannot provide final interpretations of diagnostic imaging. However, they may provide final interpretations of x-rays if they have a supervising physician as determined by NCMB rules. More details will be available in the Spring.
- All physician assistants who compound must be supervised by an NC licensed physician and are subject to traditional supervision rules, including filing an intent to practice, having supervisory arrangements, and quality improvement meetings.
Yes. Employers are free to impose any additional requirements on their employees, including quality improvement meetings.
PAs that do not qualify for team-based practice are subject to traditional NCMB rules requiring the PA to complete an intent to practice listing a NC licensed supervising physician, having a supervisory arrangement that includes the PA’s prescriptive authority, and meeting with the supervising physician for the purposes of quality improvement.
No. Team-based practice only applies to team-based settings where a majority of the practice is owned by licensed physicians. A physician owner must have consistent and meaningful participation in the design and implementation of health services to patients in order to qualify. These practices are subject to the current NCMB rules pertaining to supervision.
No. A team-based setting or team-based practice does not include medical practices that specialize in pain management. Physician assistants working in practices that specialize in pain management must follow all rules pertaining to supervision, including maintaining a supervisory arrangement with a supervising physician and having quality improvement meetings. Physician assistants must consult with their supervising physician prior to prescribing targeted controlled substances if the therapeutic use of the targeted controlled substance will or is expected to exceed a period of 30 days.
