Pennsylvania Physician Assistant Malpractice Insurance
Pennsylvania is one of the few states where a physician assistant (PA) can't legally practice without malpractice insurance. Section 36(f) of the Medical Practice Act requires at least $1,000,000 per occurrence or claims made, and a PA without it may not practice (49 Pa. Code §18.146). The state's MCARE Fund doesn't cover PAs, so that $1M has to come from your own or your employer's policy. Get an instant quote online with same-day proof.
Why Pennsylvania PAs Need Their Own Policy
Pennsylvania ties your license to your policy. If you were licensed on a carrier's letter, the license goes inactive by law 30 days after issue unless you file a certificate or declarations page, and a lapse later is grounds for discipline. Physicians here get a second layer from the MCARE Fund; PAs don't. Since January 2023, malpractice suits also aren't limited to the county where care happened. Your own policy, in your name, keeps the $1M requirement met when you change jobs, add per diem shifts, or move between an MD and a DO practice.
How much does malpractice insurance for Physician Assistants cost in Pennsylvania?
Costs are based on specialties as well as full vs part- time hours:
Average $1M/$3M Coverage Premium - Part Time (less than 24 hours/week):
$1,012 - P1 (lower-risk outpatient specialties like family practice or dermatology)
$1,317 - P2 (hospital ER, urgent care, OR work under 10 hours/week)
$1,611 - P3 (surgical or OB/GYN without L&D, trauma, pain management)
Average $1M/$3M Coverage Premium - Full Time (greater than 24 hours/week):
$1,523 - P1 (lower-risk outpatient specialties like family practice or dermatology)
$1,988 - P2 (hospital ER, urgent care, OR work under 10 hours/week)
$2,426 - P3 (surgical or OB/GYN without L&D, trauma, pain management)
Sample rates only. Premium will be underwritten for your exact situation when using our Instant Online Quote portal.
Physician Assistant Insurance cost varies depending on:
* Scope of services provided
* Claims-made vs. occurrence form
* Policy limits (standard limits are $1/$3M, but $100k/$300k, $250k/$500k, $500k/$1M and $2M/$4M limits available
* Prior claims history
**Note:** Rates will be underwritten for your exact situation.
Pennsylvania PA Practice Rules
Coverage rule: required. 63 P.S. §422.36(f) sets a minimum of $1,000,000 per occurrence or claims made; the Board accepts self-insurance, a personal policy, or acceptable employer coverage. Proof: certificate or declarations page (49 Pa. Code §18.146). Excess: the MCARE Fund covers physicians, podiatrists and nurse midwives, not PAs. Damages: no cap on compensatory damages (Pa. Const. art. III §18). Deadline: 2 years (42 Pa.C.S. §5524); the MCARE 7-year repose was struck down in Yanakos v. UPMC (2019). A certificate of merit is required (Pa.R.C.P. 1042.3).
You practice under a written agreement with a primary supervising physician (an MD for the Board of Medicine), effective when filed with the Board since Act 79 of 2021; the Board audits about 10%. One physician may supervise up to 6 PAs at any time. Countersignature of 100% of your charts within 10 days applies only for your first 12 months after licensure or in a new specialty; after that the agreement sets it (49 Pa. Code §18.142). On-site presence isn't required.
Pennsylvania Physician Assistant (PA) FAQs
Is malpractice insurance required for PAs in Pennsylvania?
Yes. Under 63 P.S. §422.36(f), every licensed Pennsylvania PA must maintain professional liability coverage of at least $1,000,000 per occurrence or claims made. Failing to keep it subjects you to discipline, and 49 Pa. Code §18.146(d) says a PA without it may not practice.
The legal floor is $1M per occurrence or claims made in Pennsylvania. Most hospitals and groups ask for $1M/$3M. With no cap on compensatory damages under Article III, Section 18 of the state constitution and no MCARE layer for PAs, surgical and emergency PAs often look at more.
How much liability coverage is standard for a physician assistant in Pennsylvania?
https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter18/s18.146.html
How much does malpractice insurance for Physician Assistants cost in Pennsylvania?
In Pennsylvania, Physician Assistant malpractice coverage can start as low as $972 annually for $100,000/$300,000 limits. At the more common $1,000,000/$3,000,000 limits, average annual premiums are roughly $1523 for Tier P1 (behavioral health, pediatrics, family practice, dermatology), $1988 for Tier P2 (ER, urgent care, surgical centers or OR work <10 hours/week), and $2426 for Tier P3 (OB/GYN without labor & delivery, trauma, pain management, higher-risk surgical). Part-time work in Pennsylvania often brings reduced premiums, roughly $1012 for Tier P1, $1317 for Tier P2, and $1611 for Tier P3. Final premiums vary by specialty, procedures, hours worked, and individual claims history.
Does an employer policy satisfy Pennsylvania's PA insurance requirement?
It can. §36(f) lets the Board accept employer-provided coverage if it's acceptable to the Board in Pennsylvania. Check that you're individually covered for at least $1M per occurrence or claims made, not just listed under a shared group limit, and get a certificate naming you for the Board.
Claims that your diagnosis, treatment, prescribing or procedures injured a patient: lawyers, experts, court costs and damages. Most Pennsylvania PA policies also include a license defense limit for the Pennsylvania State Board of Medicine.
What does a physician assistant malpractice policy actually cover in Pennsylvania?
Can physician assistants practice independently in Pennsylvania?
No. Pennsylvania PAs practice under a written agreement with a primary supervising physician, effective when filed with the Board (Act 79 of 2021), and one physician may supervise up to 6 PAs at a time. On-site presence is not required, and 100% chart countersignature within 10 days applies only in your first 12 months or a new specialty (49 Pa. Code 18.142).
https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter18/s18.158.html
Yes, if your supervising physician delegates it in the written agreement and you hold DEA registration in Pennsylvania. Schedule II is limited to a 72-hour initial dose, with the physician told within 24 hours, or a 30-day supply for approved ongoing therapy (49 Pa. Code §18.158). Query the PDMP each time you prescribe an opioid or benzodiazepine.
Can a Pennsylvania PA prescribe Schedule II drugs?
https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter18/s18.146.html
What is the statute of limitations for medical malpractice in Pennsylvania?
Generally 2 years in Pennsylvania (42 Pa.C.S. 5524). The MCARE Act's 7-year repose was struck down in Yanakos v. UPMC (2019), so there is no fixed outer limit, and the plaintiff must file a certificate of merit (Pa.R.C.P. 1042.3).
Does Pennsylvania limit how much a patient can recover in a malpractice suit?
No. Pennsylvania's constitution bars caps on compensatory damages (Pa. Const. art. III, sec. 18), and PAs are not covered by the MCARE Fund's excess layer. That is one reason Pennsylvania requires PAs to carry at least $1M per occurrence or claims made (63 P.S. 422.36(f)).
Is there a state excess fund that covers Pennsylvania PAs?
No, not in Pennsylvania. MCARE's participating providers are physicians, certified nurse midwives, podiatrists and certain facilities. PAs aren't on that list, so they don't pay MCARE assessments or get its excess layer. Your required $1M must come entirely from your own or your employer's policy.
Do I need tail coverage when I leave a PA job in Pennsylvania?
On claims-made, yes, and it's also a licensing issue: a gap in coverage for prior work can leave a claim unpaid in Pennsylvania. The deadline is 2 years, but minors' claims can generally wait until age 20, and the MCARE repose no longer applies after Yanakos. Buy tail or get prior acts before you leave.
Is occurrence or claims-made coverage better for Pennsylvania PAs?
Both satisfy §36(f), which allows $1M per occurrence or claims made in Pennsylvania. Occurrence needs no tail when you leave. Claims-made costs less early and steps up for several years, but needs tail or prior acts at each job change to keep you continuously covered for licensing.
What should a new-grad PA in Pennsylvania know about malpractice insurance?
Arrange coverage before licensure: a carrier letter can go with your application, then the certificate within 30 days in Pennsylvania (§36(f)(2)). Expect 100% countersignature of your charts within 10 days for your first 12 months (§18.142). New-grad discounts are common at $1M/$3M.
Can a Pennsylvania PA see patients by telehealth?
Yes, within your written agreement and the standard of care. The Department of State says practitioners treating Pennsylvania patients by telemedicine must hold a Pennsylvania license. Pennsylvania isn't in the PA Licensure Compact, so out-of-state patients need you licensed there and covered by your policy's territory.
Will my malpractice insurance defend my Pennsylvania PA license?
Most individual PA policies do, but the limit is far lower than the malpractice limit. Check the license defense sublimit on your declarations page and whether it covers Pennsylvania State Board of Medicine hearings.
What is the risk of practicing as a PA in Pennsylvania without malpractice insurance?
You're out of compliance with your license in Pennsylvania. 49 Pa. Code §18.146(d) says you may not practice without it, and §36(f) makes a lapse grounds for discipline. Any claim during the gap is yours to defend and pay, without an MCARE layer. Tell your employer immediately if coverage ends.
Will a malpractice claim show up on my record as a Pennsylvania PA?
Payments made on your behalf go to the National Practitioner Data Bank (45 CFR §60.7), which hospitals check at credentialing in Pennsylvania. The Board can also inspect your practice site, with or without notice, for supervision, the written agreement and records (49 Pa. Code §18.156). Keep loss runs from every carrier.
How quickly can I get covered as a PA in Pennsylvania?
Usually within a day for a clean application. The instant online quote prices Pennsylvania PA coverage in minutes; prior claims or surgical work can add underwriting time.
Did the 2023 venue change affect Pennsylvania PAs?
Yes. Until 2023, Rule 1006(a.1) required malpractice suits to be filed in the county where care happened. The Pennsylvania Supreme Court rescinded it effective January 1, 2023, so ordinary venue rules apply and a plaintiff may have more counties to choose from. That's one reason to review limits above the $1M floor.
At licensure you can file a letter from your carrier stating coverage starts when the license issues; then you have 30 days to send a certificate or declarations page, or the license goes inactive by law in Pennsylvania (63 P.S. §422.36(f)(2); §18.146(c)). Self-insurance approved by the Insurance Department also counts. Written agreements no longer need Board pre-approval.
How do Pennsylvania PAs prove malpractice insurance to the Board?
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Helpful Links:
- Physician assistant (PA) insurance guide
- PA malpractice insurance cost by state
- Instant PA insurance quotes
- Am I covered under my supervising physician's policy?
- Tail coverage for physician assistants
- Claims-made vs occurrence for PAs
- New Jersey PA malpractice insurance
- Ohio PA malpractice insurance
- New York PA malpractice insurance
- Delaware PA malpractice insurance
- Maryland PA malpractice insurance
Pennsylvania sources:
- State Board of Medicine
- State Board of Osteopathic Medicine
- 63 P.S. §422.36 (PA license; insurance requirement)
- 49 Pa. Code §18.146 (proof of insurance)
- 49 Pa. Code §18.142 (written agreements)
- 49 Pa. Code §18.158 (prescribing)
- Act 79 of 2021
- Board FAQ on Act 79 and 2025 regulations
- PA PDMP: prescriber requirements