COMAR 10.32.03 sets Maryland’s physician assistant fees, and one line item stands out.
The schedule
Initial application 00. Renewal 35. Reinstatement 00. Written verification of licensure 5. And the delegation agreement: 00.
Why that is notable
In most states the collaboration or supervision document is a requirement without a separate price — paperwork, not a fee line. Maryland charges as much for it as for the license application.
Which matters because the agreement is tied to a specific physician. Change employers, and in many arrangements the agreement changes with you. A PA who moves practices twice in Maryland has paid for the delegation agreement three times, and the total exceeds what they paid to be licensed.
The planning consequence
Budget it as a recurring cost rather than a one-off, particularly early in a career or in locum work where employers change often. And ask, before accepting a role, who bears it — some practices absorb it as a cost of onboarding and some do not, and it is a reasonable thing to raise.
Compact position
Maryland is a member state. Worth noting that a compact privilege, when privileges open, will not remove state requirements around collaboration — the privilege authorizes practice, it does not rewrite the receiving state’s practice rules.
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