Coming soon: PA team based practice
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Effective June 30, certain experienced PAs will have the opportunity to practice without the need to establish with a primary supervising physician.
This type of practice, known as PA team-based practice, was authorized through licensing provisions in HB67, which was approved in July 2025. Since then, NCMB has received multiple inquiries from licensees asking whether it is true that PAs can now practice “without supervision”. This is NOT the case. PA team-based practice is an alternative type of PA practice that involves working in specific practice environments where eligible PAs regularly collaborate, consult and refer with members of the health care team, including physicians.
Here’s how it’s going to work in NC:
• Before initiating team-based practice, PAs meeting the eligibility criteria must submit an online request seeking NCMB’s approval. This form will be available by June 30. PAs must submit supporting documentation for the following:
1. Have at least 4,000 documented hours of clinical practice as a licensed PA
2. Have at least 1,000 documented hours of clinical practice in each specialty area of practice in which the PA will practice; and
3. Will be practicing in a team-based practice setting as defined by state law.
• PAs may not begin active clinical team-based practice until they receive acknowledgement from NCMB, or confirm via NCMB’s website, that their request for team-based practice has been processed.
• The PA must notify NCMB of changes to their specialty area of practice or practice setting. If circumstances change such that the PA is no longer working in a team based setting or has less than 1,000 hours of practice in the new specialty area of practice, the PA shall become ineligible for team-based practice and would need to establish with a primary supervising physician and comply with all applicable laws and rules related to supervision.
Find a draft of the proposed administrative rules related to PA team-based practice on NCMB’s online Rule Change Tracker.
This type of practice, known as PA team-based practice, was authorized through licensing provisions in HB67, which was approved in July 2025. Since then, NCMB has received multiple inquiries from licensees asking whether it is true that PAs can now practice “without supervision”. This is NOT the case. PA team-based practice is an alternative type of PA practice that involves working in specific practice environments where eligible PAs regularly collaborate, consult and refer with members of the health care team, including physicians.
Here’s how it’s going to work in NC:
• Before initiating team-based practice, PAs meeting the eligibility criteria must submit an online request seeking NCMB’s approval. This form will be available by June 30. PAs must submit supporting documentation for the following:
1. Have at least 4,000 documented hours of clinical practice as a licensed PA
2. Have at least 1,000 documented hours of clinical practice in each specialty area of practice in which the PA will practice; and
3. Will be practicing in a team-based practice setting as defined by state law.
• PAs may not begin active clinical team-based practice until they receive acknowledgement from NCMB, or confirm via NCMB’s website, that their request for team-based practice has been processed.
• The PA must notify NCMB of changes to their specialty area of practice or practice setting. If circumstances change such that the PA is no longer working in a team based setting or has less than 1,000 hours of practice in the new specialty area of practice, the PA shall become ineligible for team-based practice and would need to establish with a primary supervising physician and comply with all applicable laws and rules related to supervision.
Find a draft of the proposed administrative rules related to PA team-based practice on NCMB’s online Rule Change Tracker.
