Protocol · PA · Nebraska
Practice Protocol for Physician Assistants in Nebraska
Required. Nebraska law names the instrument a Written Collaborative Agreement, and the clinical protocol is the content that instrument carries. Below: the board that governs it, what it must contain, and the terms it has to carry.
No independent-practice pathway exists for PAs in Nebraska — an active, board-filed supervision agreement with a supervising physician is required for as long as the PA practices (Medicine and Surgery Practice Act, Neb. Rev. Stat. §§ 38-2047, 38-2050).
What a Nebraska Written Collaborative Agreement must contain
Governed by the Nebraska Board of Medicine and Surgery and the Nebraska State Board of Pharmacy. Each numbered item is a statutory requirement the Written Collaborative Agreement must satisfy.
The Physician Assistant ("PA") shall practice pursuant to a written collaborative agreement with the Physician reflecting their collaborative relationship, as required by Neb. Rev. Stat. § 38-2050. Nebraska law does not fix a numerical limit on the number of Physician Assistants with whom a physician may enter into a collaborative agreement, but requires at least one supervising physician per employer, and at least one per specialty area where the employer operates in multiple specialties. The Physician Assistant may practice at a location geographically remote from the Physician.
Source: Neb. Rev. Stat. § 38-2050
The Physician shall keep the collaborative agreement on file at the Physician's primary practice site and at each site where the Physician Assistant practices, and shall produce it to the Nebraska Board of Medicine and Surgery upon request.
- The Written Collaborative Agreement also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
Statutes and rules these clauses cite
- Neb. Rev. Stat. § 38-2050statute
Requires a written collaborative agreement between a Physician Assistant and a collaborating physician.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the Written Collaborative Agreement has to carry, from Nebraska's supervision rules.
Proximity
Available remotely (no on-site requirement)
Statute defines supervision as 'the ready availability of the supervising physician for consultation and collaboration' — no on-site or mile/minute radius standard is codified (§ 38-2047).
Supervision ratio
Up to 4 at a time
A supervising physician may supervise no more than 4 PAs at any one time; the Board of Medicine and Surgery may waive this limit on application (§ 38-2050).
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
May prescribe Schedule II–V controlled substances under the collaborative agreement with a federal DEA registration (§ 38-2055; Uniform Controlled Substances Act, § 28-405). Nebraska sets no schedule-specific day-supply limit, unlike several states that cap Schedule II at a fixed number of days.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Nebraska has historically been unusually permissive toward corporate practice (Nebraska Supreme Court, 1905), but Neb. Rev. Stat. § 21-190 limits a professional limited liability company to rendering 'only one specific kind of professional service' — read by secondary sources as barring a single entity from being co-owned by a physician and a PA across different licensed disciplines.
Whether a PA can independently own a single-discipline PA-only entity under § 21-190, rather than needing physician ownership, is not spelled out.
Sources for the supervision rules (5)
- Neb. Rev. Stat. § 38-2047 — Physician Assistants; Services Performed; Supervision Requirementssecondary
- Neb. Rev. Stat. § 38-2050 — Physician Assistants; Supervision; Supervising Physician; Requirements; Agreementsecondary
- Neb. Rev. Stat. § 38-2055 — Physician Assistant Prescriptive Authority
- Nebraska DHHS — 2024 Statutes Relating to Physician Assistant
- Neb. Rev. Stat. § 21-190 — Professional Limited Liability Companies (single-discipline restriction)
About Nebraska's rules
LB 107 (2015) replaced ongoing APRN physician collaboration with a one-time 2,000-hour transition-to-practice period for nurse practitioners. Whether CRNAs and CNSs follow the identical threshold is not spelled out in statute; confirm before relying on those two entries. CNMs remain the most restricted category, unaffected by that reform.
Other clinicians in Nebraska: see the state overview.