Maryland charges $200 for the delegation agreement, the same amount as the license application itself, under COMAR 10.32.03. Because a new agreement is required when you change employers, the cost of switching jobs in Maryland is materially higher than in states where the agreement is a free filing.
Most states treat the collaboration document as paperwork. Maryland prices it like a license, and that changes the arithmetic on a career move.
What COMAR sets
$200 for the initial application. One hundred and thirty-five to renew. Two hundred to reinstate. Twenty-five for a written verification of licensure, which you will pay whenever another state asks Maryland to confirm your license.
And two hundred for the delegation agreement — the same as the application fee, for a document rather than a credential.
Why that number is not trivial
The agreement names a specific physician and a specific practice. Change either and a new one is required. Change employers three times in a decade, as many PAs do, and you have paid $600 in agreement fees against four hundred and five in license fees.
For a PA who works across multiple practices — locums, part-time arrangements, hospital plus clinic — the exposure is larger still, because each relationship is its own filing.
The delay matters more than the money
$200 is annoying. What actually costs you is the interval. In a state where the agreement gates practice, the new employer files, the board processes, and you wait — during which you may hold a perfectly valid license and still be unable to work at the new practice.
That interval belongs on the calendar when you negotiate a start date, and it is routinely omitted because it is invisible on any fee schedule.
How to plan around it
Ask, during the offer stage, who files the agreement and when. Some employers file the day you accept; others file the week you start, which is a fortnight of avoidable delay.
Ask whether the fee is reimbursed. Many Maryland employers pay it as a matter of course. Many do not, and it is far easier to raise before you sign than after.
Maryland is a compact member
Which is genuinely useful. A Maryland license supports privileges into every other member state from 2027, so the $200 application does work well beyond Maryland.
It does not, however, escape the delegation agreement. A privilege carries the practice rules of the state where the patient is, so a PA arriving in Maryland on a privilege faces Maryland’s agreement requirement exactly as a Maryland licensee does.
Portability solves the authority question. It never solves the practice-structure question, and Maryland is a clear illustration of the difference.
Common questions
- How much does a Maryland PA license cost?
- $200 for the initial application, $135 to renew, and $200 for reinstatement. The delegation agreement is a separate $200, and written verification of licensure is $25.
- Do I need a new delegation agreement to change employers in Maryland?
- Yes. The agreement names a specific physician and practice, so a new one must be filed when either changes — with the fee attached each time.
- What is a delegation agreement?
- A document filed with the Board of Physicians describing what the collaborating physician delegates to you. Maryland treats it as a distinct regulated instrument rather than a formality.
- Is Maryland in the PA compact?
- Yes. Maryland is a member state, so a Maryland license will support privileges in other member states once applications open.
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