April 10, 2026
Photo from Adobe Express stock images
Physician Assistants across the country are the ones many families look to when their children come down with the flu, or they have a mysterious bug that just won’t pass. Chances are if you go to a clinic the face your used to seeing is that of a Physician Assistant, or also known as a PA. It goes without saying that their role in our communities is vital, so it is equally important that we make it as easy as possible for them to continue their job. One way we can do this is to make the profession's requirements well known to both the practician and the patient so all rules are completely transparent. The more information that is made available, the more informed our healthcare workers, policymakers, and patients can be about a particular occupation. There is an overall inaccessibility of this information, which is why the Knee Center’s Annual Licensing Snapshot Database is useful.
The Knee Center has been crafting a database that is regularly updated to record all of the regulatory requirements for every licensed profession. Among these professions are, of course, Physician Assistants. The following are summarized points made from the data compiled by the center.
In every state, prospective Physician Assistants are required to carry an initial license after completing the necessary training, which varies from state to state. For this license, they must pay a fee which also varies. Texas and Oregon currently have the highest fees. In Figure 1, we see the range in the initial license fees with a select few labeled.
Figure 1: Initial Licensure Fees for Physician Assistants
After working in the field, most states require PAs to renew their license after two years, unlike particular states such as Alabama or Alaska who ask for renewal each year. These are big bucks for our Physician Assistants, regardless of how often they must pay for it. The median cost of renewal is around $200 for each caretaker. Figure 2 below illustrates the range of renewal fees in the country.
Figure 2: Physician Assistant Licensure Renewal Fees
On top of this, to ensure that they are working and gaining the knowledge they need to keep up in an ever-growing field, they have continuing education requirements. These requirements are meant to keep the care we receive top-notch but are disproportionate across states. Some states, such as Arizona, require fewer hours (~40 hours). Other states' continuing education requirements are upwards of 100+ hours, such as Delaware. Figure 3 paints those who have high requirements in a darker purple shade, where those with less are lighter.
Figure 3: Continuing Education Credit Requirements Across the U.S.
PAs can complete continuing education requirements in a variety of settings. Every hour is categorized, with most places having 2 they can be placed in. Depending on how the category is ranked, the training may have to take place in a separate, mandatory course, rather than those that can be earned through on the job experience. For these instances, in particular, the PA will have to step away from the frontlines in the workplace to have time to complete their training. This can be problematic because it means less availability for the patient.
Additional requirements required for Physician Assistants are the number of exams to take, minimum age, good moral character, and degree. These regulations tend to be more stable in the country, with small variations with few states outside of the majority. You must be above the age of adulthood and old enough to obtain the necessary master's degree in almost every state. The test of good moral character is dependent on a state’s board for background checks and information provided by the applicant for the purpose of assessing an applicant’s overall record. The only difference we see in these topics listed, mainly, is that some states have a requirement beyond the Physician Assistant National Certification Examination (PANCE) which is their own Jurisprudence exam. This exam tests the takers' knowledge of the legal implications of their practice.
PAs work with their supervising physicians to bring more efficient healthcare to those they treat. Without them, physicians would be crowded with patients. To remain licensed, they have fees to pay and courses to learn on a set cycle. The difference in regulation between states suggests that regulatory requirements are extremely subjective to lawmakers and perhaps benefit from a state-by-state comparison.