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PA Scope of Practice Series: Iowa

Posted on: February 25, 2020

Chris Square

written by

Chris Keeley

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PA scope of practice laws vary throughout the country. In this series, we will outline physician assistant scope of practice laws across all of the United States. Be sure to check back every month as we make our way state-by-state, highlighting what you need to know about each state’s unique practice laws.

Key Takeaways

In comparison to the scope of practice laws in other states, Iowa is less restrictive for PAs. Other than the state determining their scope of practice and not having full prescriptive authority, the PA can practice mostly independently.

To provide you with as much information as possible, below you will find the “6 Key Elements for PA practice” of the AAPA as well as other Iowa specific scope of practice information for PAs. Also in this article, you will find information about OTP (Optimal Team Practice), which could affect Iowa in the future.

Six Key Elements for PA Practice

Licensure as Regulatory Term: Yes

You must have an active license in the state of Iowa in order to practice.

  • If you do not have an Iowa license, it is possible to obtain one within, on average, 4-6 weeks.
  • Here at Barton Associates, we have a dedicated licensing team that will assist you through the process.

Full Rx: No

A PA may prescribe schedule II-V controlled medications such as oxycodone, fentanyl, and hydromorphone, as well as all non-controlled medication. However, a PA is not authorized to prescribe schedule II depressants.

  • With proper training or appropriate experience, a PA in Iowa can receive a federal waiver to dispense buprenorphine-containing products, as long as the supervising physician is certified, trained or permitted to treat and manage patients with opioid use disorder.
  • Typical examples of these medications are Subutex and Suboxone.

Scope Determined at the Practice Site: No

The PA’s scope of practice is outlined by state law.

  • PAs must submit their forms to the board with information about their supervising physician prior to beginning practice in the state or at the time of license renewal.

Adaptable Supervision/ Collaboration Requirements: No

Physician collaboration is not required for PAs.

  • Although physician collaboration is not required for PAs, they will be required to have face-to-face meetings as well as chart reviews. There does not need to be a supervising physician personally present.

Chart Cosignature Determined at Practice Level: No

Cosigning charts was originally implemented for physicians to demonstrate they were observing PA practice.

  • Charts are reviewed on an “ongoing basis” though every chart need not be signed and every visit need not be reviewed.
  • For PAs in remote sites with less than one year of practice, (but more than six months), weekly review and 100 percent chart signature will be required for three months.

Physician May Practice with Unlimited Number of PAs: No

Iowa physicians may practice with up to five PAs at one time.

  • This limitation is not uncommon, as there are only 12 states that do not limit the amount of PAs with which a physician may practice.
  • While this does limit the number of PAs that can work in one facility, it does ensure physicians can dedicate appropriate amounts of time to each PA under his/her supervision.

OTP (Optimal Team Practice)

All information below regarding OTP was collected from the AAPA. If you would like to read more, visit

What is it?

  • Optimal Team Practice occurs when PAs, physicians, and other healthcare professionals work together to provide quality care without burdensome administrative constraints. 

What does OTP mean for the patient?

  • When a PA isn’t legally tethered to a physician, PA employers (health systems, hospitals, and group practices) can be more flexible in determining healthcare teams.
  • Allows healthcare teams to more effectively and efficiently meet patient needs.
  • Opens up more options for patients to be seen by healthcare providers, such as PAs, especially in medically underserved communities where there are not enough physicians on staff.
  • When disaster strikes, medical volunteers are vital resource to relief efforts. OTP allows PAs to provide volunteer medical services during a disaster or emergency.

What does OTP mean for me as a PA?

  • Allows PAs to practice more independently by not requiring physicians to have a specific relationship with PAs.
  • Healthcare teams can be determined on a case-by-case basis at the practice level, providing the opportunity for physicians to different PAs on different cases.
  • Allows physicians to work with PAs more easily when they are employed in hospitals, health systems, and other corporate structures that use staffing companies. Currently, PAs are often prevented from participating in these staffing arrangements since, unlike NPs, they are not eligible for direct payment, and, therefore, cannot reassign their insurance reimbursements to the staffing company.

Are you interested in practicing in Iowa? Speak to a Barton Associates agent today about our open positions!

Chris Keeley
About Chris Keeley

Chris Keeley is the content marketing copywriter and former recruiter at Barton Associates' Peabody, MA, headquarters. Native to the Boston area, Chris joined the Barton team in May 2019 after earning his degree is communications from Salem State University partnered with completing a sport-marketing program in Rotterdam, Netherlands.

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