How to own a Practice as a Physician Assistant

PA School • October 20, 2023

If you’re a PA dreaming of building your practice, you’re in the right place. Join us as we unravel the secrets and challenges. In this article we will discuss how to own a practice as a physician assistant!

How to Own a Practice as a Physician Assistant

Physician Assistants (PAs) have been an integral part of the healthcare system for years, providing essential care under the supervision of physicians. While many PAs excel in clinical roles, some aspire to take their careers to the next level by owning their own practices. This might sound surprising to some, but it’s indeed possible. In this article, we will explore the steps and considerations for PAs who want to own and operate their own practices.

Dispelling the Myths

First and foremost, it’s important to address the misconception that PAs cannot own their own practices. While there are state-specific regulations that dictate the scope of practice and business ownership for PAs, there have been significant developments in recent years.

In 2022, Medicare and various insurance companies agreed to pay PAs directly for their professional services. This agreement opened up opportunities for PAs to establish and run their practices independently, receiving direct payment for their services.

However, it’s crucial to note that state laws vary, and in some states, PAs may not be allowed to own 100% of professional corporations. California, for example, has such regulations in place. In such cases, PAs can collaborate with a physician as co-owners, with the PA owning 49% and the physician owning 51% of the practice.

Setting Up Your PA Practice

Once you’ve navigated the legal requirements and determined your ownership structure, the process of setting up your PA practice is similar to starting a business in any field. Here are the essential steps:

1. Obtain a Business License

Every business needs to operate legally, and obtaining a business license is the first step. Ensure you comply with local regulations and obtain the necessary permits.

2. Choose Your Business Structure

Decide whether you will operate as a sole proprietor or set up a Limited Liability Company (LLC). The choice of structure can have implications for taxation and liability, so consult with legal and financial experts.

3. Maintain Active PA License

You must hold an active and valid PA license in your state to practice. Ensure you are in good standing with the licensing board.

4. Acquire a DEA License

For prescribing medications, you will need a Drug Enforcement Administration (DEA) license. This is essential for PAs engaged in many medical specialties.

5. Establish a Supervision Agreement

Comply with your state’s regulations regarding the supervising physician agreement. This document outlines the terms and conditions of your PA practice, including the physician’s role in overseeing your work.

6. Research Credentialing

Credentialing is the process of verifying your qualifications and setting up contracts with insurance companies. Consider hiring a credentialing service to streamline this process.

7. Implement Billing Systems

You’ll need an efficient billing system to manage the financial aspects of your practice. This includes submitting claims to insurance providers and ensuring timely reimbursement.

8. Marketing Your Practice

Effective marketing is crucial for attracting patients to your practice. Establish an online and offline marketing strategy to reach your target audience.

9. Electronic Medical Records

Implement electronic medical record (EMR) systems to streamline patient care, record-keeping, and communication within your practice.

State Laws and Scope of Practice

As mentioned earlier, state laws can significantly impact the ability of PAs to own and operate their practices. Scope of practice regulations can vary from state to state, so it’s vital to understand these differences. Some states grant PAs full practice authority, allowing them to provide a broad range of medical services independently. In contrast, others may have more restrictive regulations.

This is where collaborating with a physician as a co-owner can be beneficial, as it ensures compliance with state laws while still allowing you to run your practice effectively.

PAs vs. Nurse Practitioners

PAs are not the only healthcare professionals who can own and operate their practices. Nurse practitioners (NPs) also have this opportunity in most states. The key difference lies in the process, as NPs often have more consistent independence in their practice authority, while PAs may face variations depending on their location.

The Importance of Collaboration

Regardless of how you set up your practice, having a collaborating physician or a medical director is crucial. Their presence can provide additional expertise, guidance, and support, especially in the early stages of practice ownership.

The Posh PA: A Real-Life Example

To illustrate the possibility of owning a practice as a PA, consider the case of “The Posh PA,” a virtual LLC owned and operated by a practicing PA. In this example, the business is entirely separate from the clinical PA license, and the focus is on non-clinical services. This demonstrates that PAs can leverage their skills and knowledge in various ways to meet their entrepreneurial aspirations.


Owning a practice as a Physician Assistant is not only possible but also an exciting opportunity for those willing to navigate the legal and regulatory landscape. If you’re considering this path, it’s crucial to understand your state’s laws, collaborate with a physician when required, and carefully follow the steps for setting up and operating your practice.

Starting your own practice takes time, effort, and dedication. However, with the right preparation and a clear vision, it’s an achievable goal for PAs who want to take control of their professional destinies. So, if you’re a PA with the dream of owning your practice, do your research, seek legal and financial counsel, and make your entrepreneurial dreams a reality. The healthcare industry is evolving, and PAs are making their mark as practice owners.

Also read: Exploring International Opportunities for Physician Assistants

About me:

I’m Michele Neskey, aka The Posh PA. Welcome to my YouTube channel! My mission is to provide personalized guidance, education, and motivation to build confidence and promote wellness for aspiring physician assistants and beyond.   

Having been a PA for 17+ years and helped hundreds of students gain acceptance into PA school,  I understand the admissions process. I know what they are looking for, and I can help you tailor every component to make you shine, giving you the BEST chance of getting accepted to a program.  But it doesn’t end there. I create personalized plans for PA students and practicing PAs including test-taking strategy for the PANCE, contract negotiations, and tools to overcome and prevent provider burnout. 

My goal is to get you into a physician assistant (PA) school & survive the rigorous program, help you prevent burnout as a practicing PA, and help you take care of yourself so you can be the best version of YOU for your patients, family, and most importantly YOU!