Do You Need Your Own Malpractice Insurance as a PA?
You already know the short answer: probably yes. But let’s be clear about why. Even if your employer carries a policy, that policy protects the employer first. It may not defend your license, it may not cover you after you leave, and it may settle a claim without your consent. For physician associates—especially those in states with full practice authority—the risk is real and growing.
CM&F Group has been insuring clinicians since 1919 and is the official insurance partner of the American Academy of Physician Associates (AAPA). They see the shift firsthand: as PAs gain more autonomy, their liability profile changes. This guide walks you through what to look for, what to avoid, and how much coverage makes sense.
How Does Practice Authority Affect Your Liability?
The AAPA classifies state practice environments into four tiers: optimal, advanced, collaborative, and supervisory. In an optimal practice state, PAs can practice to the full extent of their education and training without a formal supervisory agreement. That’s great for your career, but it also means you’re making more independent decisions—and bearing more of the risk.
When you work under a supervising physician, the liability often falls on the physician or the practice. But when you practice independently, you become the primary target in a lawsuit. Your own policy ensures you have dedicated legal representation and coverage that follows you, not your employer.
Prescribing Liability: A Growing Concern
Prescribing is one of the highest-risk activities for PAs. Consider this: a patient walks into urgent care with a cough and earache. The PA prescribes a fluoroquinolone antibiotic and a short course of steroids. Routine, right? Except the patient is 67, and the FDA has carried a boxed warning since 2008 about fluoroquinolone-associated tendon injury in patients over 60 and those on corticosteroids. Weeks later, the patient develops Achilles tendinopathy, cannot walk, and files a lawsuit.
This is not rare. PAs with prescriptive authority must be especially careful about documentation, patient risk factors, and drug interactions. Your malpractice policy should cover prescribing errors, and it should include license defense coverage to protect your credential if a complaint is filed with the state board.
Occurrence vs. Claims-Made: What’s Right for You?
This is the most important decision you’ll make when buying a policy. Here’s the plain-language difference:
- Occurrence: Covers any incident that happened while the policy was active, no matter when the claim is filed. You don’t need tail coverage. This is simpler and often preferred by PAs who change jobs or retire.
- Claims-made: Only covers claims filed while the policy is active. If you cancel or switch carriers, you need tail coverage (extended reporting endorsement), which can cost 1.5–2x your annual premium.
Most carriers like HPSO/NSO, Proliability, and Berxi offer both options. Berxi’s policies are occurrence-based by default, with defense costs outside the limits—meaning your full limit is preserved for settlements or judgments. CM&F Group offers up to $1M/$6M portable occurrence coverage with telemedicine and license defense included.
How Much Coverage Should a PA Carry?
Typical limits for PAs are $1 million per occurrence and $3 million aggregate ($1M/$3M). Some carriers offer $1M/$6M. For most employed PAs, $1M/$3M is adequate—but if you own your own practice or work in a high-risk specialty (e.g., surgery, emergency medicine), consider higher limits.
Annual premiums for PAs generally range from about $500 to $1,500, depending on your specialty, state, and whether you’re employed or self-employed. Final pricing comes from the carrier at quote, so always compare a few options.
What About Starting Your Own Practice?
If you’re opening a PA-owned practice, your insurance needs multiply. You’ll need professional liability for yourself, plus general liability, cyber liability, and possibly workers’ compensation. State laws vary—Massachusetts, for example, doesn’t allow PAs to own practices outright due to corporate practice of medicine (CPOM) rules. Check your state’s regulations before you lease office space.
Patterson, a PA who launched her own practice in Massachusetts, says she underestimated the complexity of legal compliance and insurance requirements. Her advice: find a healthcare attorney and an insurance broker who understands PA practice. A policy designed for a solo practice is different from one for a large group.
How to Choose a Carrier
Not all malpractice carriers are equal. Here are the key features to look for:
- License defense coverage: Should be included (typically up to $25,000 per incident). Employer policies often exclude this.
- Portability: The policy stays with you between jobs.
- Consent to settle: You should have the right to approve any settlement. Some employer policies let the insurer settle without your input.
- Telemedicine coverage: Essential if you see patients remotely.
Top carriers for PAs include CM&F Group (AAPA-endorsed), CPH & Associates (occurrence policies with $35k license defense), and Berxi (defense outside limits, $0 deductible). For a full comparison, see our carrier comparison hub.
What If You’re a Student or New Grad?
If you’re still in PA school or recently graduated, you may be covered under your school’s policy during clinical rotations. But once you graduate, that coverage ends. Many carriers offer discounted “new grad” policies or student coverage. Don’t wait until you’re in a job to buy a policy—claims can arise from incidents during training.
One Honest Caveat
The price ranges and coverage details in this guide are based on publicly available information and industry norms as of 2025. Your actual quote will depend on your specific practice setting, claims history, location, and the carrier’s underwriting criteria. Always read the policy wording carefully and consult with a licensed insurance agent if you have questions.
For more detailed profession-specific guidance, see our guides for nurse practitioners, registered nurses, and therapists.