Protocol · PA · South Dakota
Practice Protocol for Physician Assistants in South Dakota
Required. South Dakota 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.
Pathway created by SL 2025, ch 149 (eff. 2025), which also repealed SD's old PA-per-physician ratio cap entirely (36-4A-29 series). Even a PA who has NOT yet met this threshold practices under 'collaboration,' not supervision — no physical-presence or ratio requirement applies either way (see below).
Independent practice requires: certified by the National Commission on Certification of Physician Assistants (NCCPA); ≥6,000 practice hours as a PA; affidavit filed with the SD Board of Medical and Osteopathic Examiners attesting to the above (SDCL 36-4A-1.2).
What a South Dakota Written Practice Agreement must contain
Governed by the South Dakota Board of Medical and Osteopathic Examiners and the South Dakota Board of Pharmacy. Each numbered item is a statutory requirement the Written Practice Agreement must satisfy.
Unless the Physician Assistant ("PA") is certified by the National Commission on Certification of Physician Assistants and has filed an affidavit with the South Dakota Board of Medical and Osteopathic Examiners attesting to completion of at least six thousand (6,000) practice hours, the Physician Assistant shall practice pursuant to a written practice agreement with the Physician, as required by S.D. Codified Laws § 36-4A-26.1.
The practice agreement shall prescribe the delegated activities the Physician Assistant may perform and any other information the Board requires to describe the Physician Assistant's level of competence and the supervision the collaborating physician provides. South Dakota law does not fix a numerical limit on the number of Physician Assistants with whom a physician may enter into a practice agreement.
- 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 South Dakota's supervision rules.
Proximity
No proximity requirement
SDCL 36-4A-26.1: 'Collaboration does not require the physical presence of the appropriate health care provider at the time or place the physician assistant provides services.' The degree of collaboration is set by the employing facility/practice's own policies, not a statutory radius or on-site rule — applies regardless of whether the PA has met the 6,000-hour threshold.
Supervision ratio
Not codified — no cap on file
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
Individual DEA registration is the typical practical prerequisite for controlled-substance prescribing but was not separately confirmed in this section's text — verify with the Board before relying on this for Schedule II specifically.
Written agreement
Required
Only a PA who has NOT filed the 6,000-hour affidavit needs a written 'collaborative agreement' with a physician (SDCL 36-4A-1.1) — once filed, no agreement of any kind is required (36-4A-1.2). Unlike most states, even the pre-threshold agreement does not impose supervision-style day-to-day constraints; see proximity below.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Probably a physician-owned professional corporation, consistent with the common multi-state pattern; South Dakota's own healing-arts professional-corporation statute should be checked
Verify SD's specific professional-corporation/CPOM statute before relying on this for an ownership structure decision.
Sources for the supervision rules (3)
About South Dakota's rules
SD is unusually permissive: NP/CNM need only 1,040 practice hours (or a collaborative agreement with ANY physician OR already-independent NP/CNM) to become fully independent (SDCL 36-9A), and a 2025 reform (SL 2025, ch 149) gives PAs the same kind of pathway after 6,000 hours plus NCCPA certification. Older sources citing a fixed PA-per-physician ratio are now outdated — that cap was repealed.
Other clinicians in South Dakota: see the state overview.