Texas Physician Assistant Malpractice Insurance
No Texas law requires physician assistants (PAs) to carry malpractice insurance, yet most Texas PAs must: many hospitals require it for privileges, and employers and payers write it into contracts. Texas law also gives your supervising physician and your employer legal responsibility for your care, so one claim can name all three of you. Below: the Texas Physician Assistant Board rules, prescriptive authority agreements, the $250,000 damages cap and tail. Quote online and get same-day proof.
Why Texas PAs Need Their Own Policy
Texas spreads legal responsibility for a PA's care across three parties. Your supervising physician retains it, and an employer that hires you shares it (Tex. Occ. Code §204.207). But a physician is not liable just for signing your prescriptive authority agreement (§157.060), and an employer's policy is written for the employer. When a claim names all three, those interests can split over who controls the defense, who agrees to settle and whose limits pay. Your own policy gives you your own defense and your own limits. It also protects your license: the PA Board can discipline a PA for repeated meritorious liability claims (§204.304), and any malpractice payment made for you is reported to the National Practitioner Data Bank and the Texas board (45 CFR §60.7). The $250,000 cap applies only to non-economic damages; medical bills and lost earnings are not capped outside wrongful-death cases (Civ. Prac. & Rem. Code §§74.301, 74.303). A personal policy can also follow you to moonlighting, locums and telemedicine shifts.
How much does malpractice insurance for Physician Assistants cost in Texas?
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.
Texas PA Practice Rules
Insurance requirement: none in statute. Neither the Physician Assistant Licensing Act (Tex. Occ. Code ch. 204) nor the PA Board rules (22 TAC ch. 183, which replaced ch. 185 on Jan. 9, 2025) require PA malpractice coverage; hospitals, employers and payers set it, most often at $1M per claim / $3M aggregate. How a Texas claim works (Civ. Prac. & Rem. Code ch. 74): the patient must send written notice by certified mail at least 60 days before suing (§74.051) and serve an expert report within 120 days of your answer or face dismissal (§74.351). Suits must be filed within 2 years of the alleged error or the end of treatment, with a 10-year outer limit; children under 12 have until age 14 (§74.251). Non-economic damages are capped at $250,000 per claimant across all physicians and providers combined (§74.301). Wrongful-death damages are capped at $500,000 adjusted for inflation since 1977, not counting medical care (§74.303). For emergency care in a hospital emergency department, the patient generally must prove willful and wanton negligence (§74.153). Texas has no patient compensation fund. Buying tip from the Texas Department of Insurance: licensed carriers can't cancel after a policy's first 90 days and are backed by the state guaranty association; surplus lines carriers are not.
Texas PAs practice under supervision and delegation, not collaboration. Supervision must be continuous but not on-site; your physician must be reachable by phone or other telecommunication (Tex. Occ. Code §204.204). Prescribing runs through a written prescriptive authority agreement, reviewed yearly, with chart review in a number you and your physician choose and documented meetings at least monthly (§157.0512). Texas has no hours-based path to independent practice.
Texas Physician Assistant (PA) FAQs
Is malpractice insurance required for PAs in Texas?
Not by statute. Texas Occupations Code ch. 204 and the PA Board rules in 22 TAC ch. 183 contain no insurance requirement. In practice most Texas PAs must carry it: hospitals require it for privileges, and employers and payers put it in contracts. Before relying on an employer's policy, ask whether you are a named insured, whether it is claims-made or occurrence, and who pays for tail if you leave.
Texas sets no minimum for PAs, so your contracts decide. $1M per claim / $3M aggregate is the common hospital and group standard, and some groups ask for more. Don't lower limits because of the damages cap: it covers only non-economic damages, and one $250,000 cap is shared by all physicians and providers sued by the same claimant.
How much liability coverage is standard for a physician assistant in Texas?
How much does malpractice insurance for Physician Assistants cost in Texas?
For Texas, malpractice insurance for Physician Assistants can be priced from about $972 per year at entry-level $100,000/$300,000 limits. For standard $1M/$3M coverage, expect typical costs of about $1523 for P1 specialties (pediatrics, behavioral health, dermatology, family practice), $1988 for P2 (ER, urgent care, surgical centers under 10 hrs/week), and $2426 for P3 (OB/GYN excluding labor & delivery, trauma, high-risk surgical). Part-time Physician Assistants in Texas usually see lower rates, averaging $1012, $1317, and $1611 across the same P1P3 tiers. Premiums ultimately reflect specialty, procedures, venue, and malpractice history.
Will my clinic's malpractice insurance cover me as a Texas PA?
Sometimes, but it isn't the same as your own in Texas. Added coverage usually shares the physician's limits, the physician's carrier controls the defense, and it ends when you change jobs. If you accept it, get the certificate every year, confirm you are named, and check who can consent to a settlement and whether defense costs reduce the limits. A personal policy keeps separate limits and your own defense.
Defense costs and damages for professional negligence. It does not cover intentional acts, crimes or premises claims like falls, so Texas PAs should list every site and service they provide.
What does PA malpractice insurance cover in Texas?
Can a Texas PA work without a supervising or collaborating physician?
No. Texas PAs practice under physician supervision and delegation, and there is no hours-based path to independent practice. Supervision must be continuous but not on site, with the physician reachable by phone or other telecommunication (Tex. Occ. Code 204.204), and prescribing runs through a prescriptive authority agreement with documented meetings at least monthly (157.0512).
Only in two situations: for hospital patients admitted for an intended stay of 24+ hours or seen in that hospital's emergency department, under medical-staff policy; and for hospice patients (Occ. Code §157.0511). A freestanding ER doesn't qualify. Elsewhere you can prescribe Schedules III-V for up to 90 days including refills; a refill after that, or any controlled substance for a child under 2, needs a charted consult with your physician. You need a DEA registration; Texas ended its state registration in 2016.
Can PAs prescribe controlled substances in Texas?
How long does a patient have to sue a PA for malpractice in Texas?
Two years from the alleged error or the end of the course of treatment in Texas, with a 10-year outer limit; children under 12 have until age 14 (Tex. Civ. Prac. & Rem. Code 74.251). The patient must also send written notice at least 60 days before suing (74.051) and serve an expert report within 120 days of your answer (74.351).
Does Texas cap malpractice damages?
Yes. Texas caps noneconomic damages at $250,000 per claimant across all physicians and health care providers combined (Tex. Civ. Prac. & Rem. Code 74.301). Wrongful-death damages are capped at $500,000 adjusted for inflation since 1977, not counting medical care (74.303), and economic damages such as medical bills and lost wages are not capped.
Does Texas have a patient compensation fund for PAs?
No. Texas has no state fund that pays claims above your policy limits, so your own limits are the ceiling. The state's backstops work differently: the Texas Medical Liability Insurance Underwriting Association (JUA) insures providers turned down by at least two licensed carriers, and the Texas Property and Casualty Insurance Guaranty Association covers policyholders of a failed licensed carrier up to $300,000 per claim (Texas Department of Insurance).
Do I need tail coverage when I leave a PA job in Texas?
On a claims-made policy, yes, or a new carrier must pick up your retroactive date with prior-acts (nose) coverage. The Texas Department of Insurance says tail may cost 1.5 to 3 times an annual premium. Who pays is set by your employment contract, so settle it before you sign. Claims can arrive up to 2 years after treatment, and later for children under 12 (Civ. Prac. & Rem. Code §74.251).
Is occurrence or claims-made coverage better for Texas PAs?
Occurrence covers incidents during the policy period whenever the claim arrives. Claims-made covers claims reported while the policy is active for incidents after the retroactive date; it costs less early, then rises for about 5 years. Most PA policies are claims-made. With a licensed Texas carrier you also get 90 days' notice of nonrenewal or a premium increase, and no surcharge for claims that weren't paid (TDI).
How should a new graduate PA in Texas set up malpractice coverage?
Plan around the licensing calendar. Texas issues PA licenses once a month; a temporary license ($107 affidavit) can bridge the gap after approval. Register your supervising physician before your first shift, then get your DEA registration if you'll prescribe controlled substances. Set your policy to start on day one. New-grad PAs can usually get $1M/$3M coverage right away, often with a first-year discount.
Am I covered for telemedicine as a PA in Texas?
It should, so confirm it in writing. Texas treats telemedicine by a PA under a Texas physician's delegation as a telemedicine medical service, held to the same standard of care as an in-person visit (Occ. Code §§111.001, 111.007). Texas has not joined the PA Licensure Compact; the 2025 bill, HB 1731, died in a Senate committee. If you see patients located in other states, you need to be licensed where they are, and the policy territory must include those states.
Do Texas PAs need license protection coverage?
Often, but not always on group plans. If the Texas Physician Assistant Board sends you a complaint letter, call your carrier before you answer it; license defense coverage pays the attorney who prepares your response.
What happens if a Texas PA practices without malpractice insurance?
You pay for your own defense from the first letter. A Texas claim starts with a certified-mail notice at least 60 days before suit, and the patient's expert report follows within 120 days of your answer. Your employer shares legal responsibility (Occ. Code §204.207), but its lawyers represent the employer. A payment made for you is reported to the National Practitioner Data Bank, and contracts that require coverage can end your privileges.
Do malpractice settlements get reported to the Texas PA licensing board?
Payments are. Any malpractice payment made for your benefit is reported to the National Practitioner Data Bank and the Texas board (45 CFR §60.7). The PA license application asks for your NPDB report and any malpractice records, and some forms go to your liability carrier (22 TAC §183.10; Texas Medical Board). Separately, you must report criminal matters, discipline and address changes within 10 days (§183.20). Answer every claims question on renewal and credentialing forms completely.
How fast can a PA get malpractice insurance in Texas?
Yes. Get an instant online quote, pick limits and occurrence or claims-made, and apply online; most Texas PAs receive proof of coverage the same day.
Do Texas emergency medicine PAs face different malpractice rules?
Yes, in three ways. In Texas, for care in a hospital ED before the patient is stabilized, a patient must prove willful and wanton negligence, not ordinary negligence (Civ. Prac. & Rem. Code §74.153). Freestanding ERs don't count as hospital EDs for Schedule II prescribing. And a 2025 law requires PAs who work in an emergency room setting to complete 2 hours of CME on sexual-assault care and forensic evidence (Occ. Code §204.1563).
The supervision rules don't change, but med spa work adds two checks. A Texas med spa PA still needs a supervising physician, and that physician must register your practice locations with the board within 30 days (22 TAC §169.5). Your prescriptive authority agreement must list your practice settings (Occ. Code §157.0512). On the insurance side, list every aesthetic procedure you perform, such as neurotoxins, fillers and lasers, so none falls outside your policy.
Do PAs working in med spas need different malpractice insurance in Texas?
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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
- Oklahoma PA malpractice insurance
- New Mexico PA malpractice insurance
- Louisiana PA malpractice insurance
Texas sources:
- Texas Physician Assistant Board
- Tex. Occ. Code ch. 204 (Physician Assistant Licensing Act)
- Tex. Occ. Code ch. 157 (delegation and prescriptive authority)
- Texas Medical Board: prescribing and supervision
- Tex. Civ. Prac. & Rem. Code ch. 74 (medical liability)
- Texas Department of Insurance: medical liability shopping guide