Ask about their specialty and collaboration experience, how many NPs or PAs they already work with, how quickly they respond, how they handle chart review, and how they would handle a disagreement on a treatment plan. The full guide includes more than 40 questions covering the physician, the agreement, compliance, malpractice, continuity, and pricing.

Compare what each option includes before your compare price. A low monthly fee usually comes from one of two things: the physician collaborates with a high number of clinicians, or services have been removed. Look at total annual cost, what happens if your physician leaves, and who handles the agreement, chart review, and malpractice coverage for the collaboration.

There are four main paths: your own professional network, direct outreach to an independent physician, matching marketplaces and directories, and full-service collaboration organizations. The right choice depends on how much of the vetting, agreement drafting, and compliance tracking you are prepared to manage yourself.

A strong agreement covers parties and scope, every element your state requires, each party’s responsibilities, communication and response expectations, chart review and meetings, prescriptive authority, fees, malpractice coverage, term and renewal, termination notice, transition plans, and records access. Generic language that could apply in any state is a warning sign.

It depends on your state. AANP groups states into full practice, reduced practice, and restricted practice environments. Reduced and restricted states require a collaborative agreement or physician supervision for at least part of your practice. Even in full practice states, you may need one during transition-to-practice hours, when licensed in multiple states, or when a payer, employer, or platform requires it.

Most states still require PAs to have some form of documented physician relationship, even where the law has moved from “supervision” to “collaboration” language. PA rules often differ from NP rules in the same state, so check AAPA’s state scope of practice resources and your state board of medicine for your license type.

There are four main paths: your own professional network, direct outreach to an independent physician, matching marketplaces and directories, and full-service collaboration organizations. Each trades cost against time, support, and risk. The right choice depends on how much of the vetting, agreement drafting, and compliance tracking you are prepared to manage yourself.

Your own policy covers your care, but the collaborating physician also carries risk, and their standard policy may not cover it. Some arrangements include collaboration-specific coverage for the physician; others charge for it separately or require you to buy it. Ask directly, and make sure the agreement states who covers it and who pays.

Without a transition plan, you may have to stop certain services or stop seeing patients until you find a new collaborator. Before you sign, ask whether there is a backup physician, how quickly a replacement can be found in your state, whether there is a rematch fee, and whether you would have a gap in coverage.

Collaborating physician pricing is not standardized, and the monthly fee is rarely the full cost. To compare options fairly, estimate a true annual cost that includes every fee type below plus the cost of a coverage gap if your physician leaves.

• Monthly collaboration fee: the recurring charge for the physician relationship
• Onboarding or matching fee: a one-time charge that often pays for vetting, matching, and agreement setup
• Per-state fees: added for each additional state you practice in
• Controlled substance add-ons: added when your physician supports scheduled prescribing
• Chart review fees: charged per chart or per session in some arrangements
• Malpractice charges: for the physician’s collaboration coverage, or a requirement that you buy it
• Replacement or rematch fees: charged to find a new physician if yours leaves
• Early termination fees: charged for ending before the term is up