Practice Protocol
Build an agreement

Protocol · PA · Oklahoma

Practice Protocol for Physician Assistants in Oklahoma

Required. Oklahoma law names the instrument a Written Practice 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.

Practice authorityConditional independence
Written agreementAgreement required
What Oklahoma calls itWritten Practice Agreement
Governing boardOklahoma State Board of Medical Licensure and Supervision and the Oklahoma State Board of Pharmacy
Agreement familyCollaborative Practice
Research date2026-09-03 · clauses 2026-09-03

Before H.B. 2584, PAs had no independent-practice pathway in Oklahoma at all. The reform 'permits experienced PAs to practice without a formal supervising physician when they meet statutory criteria and maintain appropriate collaborative relationships and professional liability coverage'; the specific threshold should be confirmed with the Board.

Independent practice requires: Experience-based threshold created by H.B. 2584 (2025, eff. Nov. 1, 2025); the hour or year figure and application criteria are set by the Board of Medical Licensure and Supervision.

What an Oklahoma Written Practice Agreement must contain

Governed by the Oklahoma State Board of Medical Licensure and Supervision and the Oklahoma State Board of Pharmacy. Each numbered item is a statutory requirement the Written Practice Agreement must satisfy.

  1. Unless the Physician Assistant ("PA") has completed six thousand two hundred forty (6,240) postgraduate clinical hours and qualifies to practice without a supervising physician under Oklahoma's independent-practice pathway (in which case the Physician Assistant may not prescribe Schedule II controlled substances), the Physician Assistant shall practice pursuant to a written practice agreement with the Physician, specifying the delegated medical acts and practice locations, as required by 59 O.S. § 519.1 et seq.

  2. The practice agreement shall be filed with the Oklahoma State Board of Medical Licensure and Supervision (or the Oklahoma State Board of Osteopathic Examiners, if the Physician is a doctor of osteopathic medicine) within ten (10) business days of execution. A physician may not supervise more than six (6) Physician Assistants and Nurse Practitioners combined for prescriptive-authority purposes, absent a Board-approved exception. The Physician Assistant may hold practice agreements with more than one physician.

  3. The Written Practice Agreement also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.

Terms it has to carry

Ratio, proximity, chart review, meeting and prescribing terms the Written Practice Agreement has to carry, from Oklahoma's supervision rules.

Proximity

PA below the H.B. 2584 independence threshold: Available remotely (no on-site requirement)

No geographic/proximity requirement is codified; the supervising physician need not even be physically located in Oklahoma. Availability standard is 'direct contact, telecommunications, or other appropriate electronic means for consultation, assistance with medical emergencies, patient referral.'

Supervision ratio

PA below the H.B. 2584 independence threshold: Up to 6 at a time (combined across provider types)

OAC 435:10-13-2 caps a supervising physician at 6 PAs and NPs combined, waivable by the Board on request. One secondary source describes this cap as still in force after the H.B. 2298 and H.B. 2584 reforms; another describes post-reform Tier 1 (supervised) APRNs as having no ratio cap. Confirm the cap's continued applicability against the current rule text.

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

Schedule I and II controlled substances are excluded by the statutory exclusionary formulary (63 O.S. § 2-312(C)); Schedule III–V limited to a 30-day supply, including time-released formulations. Requires federal DEA and Oklahoma Bureau of Narcotics and Dangerous Drugs (OBNDD) registration.

Written agreement

Required

Required for PAs below the H.B. 2584 independence threshold (unconfirmed exact figure); not required once independent status is granted.

Practice ownership (corporate practice of medicine)

Non-licensee ownership permitted — Oklahoma has no corporate-practice-of-medicine doctrine and no statute specifically restricting CPOM — the state's Professional Corporation Act does not bar non-physician (including PA) ownership of a medical entity the way many CPOM states do (Okla. Att'y Gen. Op. 77-168, Aug. 29, 1977).

Secondary-sourced (compliance-guide) characterization of a 1977 A.G. opinion and the absence of a modern CPOM statute — worth confirming nothing has changed since, given how old the opinion is.

Sources for the supervision rules (5)
How the relationship works day to day
Who has to be where, how often you meet, and what the physician costs: Physician Assistant in Oklahoma on collaborativeagreement.com.

About Oklahoma's rules

HB 2298 (APRNs) and HB 2584 (PAs), both 2025 and effective Nov. 1, 2025, created new hours-based independent-practice pathways in a state with no prior pathway for either. Being this recent, secondary sources conflict on whether a 6-provider physician-ratio cap (OAC 435:10-13-2) still applies post-reform — flagged per-provider below rather than guessed. Oklahoma has no corporate-practice-of-medicine doctrine (Okla. A.G. Op. 77-168).

Other clinicians in Oklahoma: see the state overview.