PA and NP employment contract checklist, clause by clause

Read the agreement with a pen and this list beside it. For each item, write one of three things in the margin: fine, question, or change. When you finish, you will have a short list of questions for the employer and a shorter list of changes to request. Send both in one email, and bring the final draft to an attorney.

• Is your base pay stated as an annual salary or an hourly rate, and is the number in the contract the same as the offer letter?
• Is pay tied to a specific number of hours, shifts or patient visits? What happens if you work more?
• How and when are raises decided? Is there a scheduled review date?
• Are bonuses described with a formula, or left to the employer's discretion?
• Sign-on and relocation: when are they paid, and what are the repayment terms if you leave early or are terminated?
• Does the contract say what happens to earned but unpaid bonus money when employment ends?

Compare the base to the BLS percentiles for your state before you sign. See physician assistant salary by state and nurse practitioner salary by state.

If any part of your pay depends on productivity, the definitions matter more than the dollar rate. Look for an exact formula in the contract, not a reference to a policy the employer can change.

• What is measured: wRVUs, visits, collections or net revenue?
• What is the dollar rate per unit, and what threshold must you pass before the bonus starts?
• Which work counts as yours? Ask specifically about shared or split visits, procedures, and work billed under a physician.
• How often is the bonus calculated and paid, and can an overpayment be taken back later?
• Can you see the reports used to calculate your bonus?
• Can the employer change the formula during the term, and does it need your written agreement to do so?

Our guide to negotiating a PA or NP job offer explains how wRVUs work and what to ask before you trade base pay for productivity.

• Radius: How many miles, and measured from where? Your primary clinic, or every location the employer operates?
• Duration: How long after employment ends does it last?
• Scope: Does it bar all clinical work, or only your specialty?
• Trigger: Does it apply no matter how employment ends, including termination without cause or the employer's breach?
• Buyout: Is there a stated price to buy your way out?
• Non-solicitation: Are there separate limits on contacting patients or recruiting staff after you leave?

Texas. In 2025 Texas passed SB 1318, which amended Section 15.50 of the Business and Commerce Code and added a new Section 15.501. The existing physician rules in Section 15.50(b) apply to a person licensed as a physician by the Texas Medical Board, so they are written for physicians, not for PAs or NPs. The new Section 15.501 covers health care practitioners, defined to include physician assistants licensed under Chapter 204 of the Occupations Code and persons licensed under Chapter 301 of the Occupations Code to engage in professional or vocational nursing.

Under Section 15.501, a non-compete relating to practice as a physician assistant, or to nursing, is not enforceable against a covered practitioner unless it meets four conditions: it provides for a buyout no greater than the practitioner's total annual salary and wages at the time of termination; it expires no later than one year after the contract or employment ends; it limits the area to no more than a five-mile radius from where the practitioner primarily practiced; and its terms are clearly and conspicuously stated in writing. The changes apply only to a covenant entered into or renewed on or after the Act's effective date, and the Act took effect September 1, 2025.

Two cautions. First, SB 1318 also made a physician's non-compete void if the physician is involuntarily discharged without good cause, but that subsection is written for physicians licensed by the Texas Medical Board, and Section 15.501 does not contain the same language. Second, if you are a Texas NP or CRNA, the statute refers to nurses licensed under Chapter 301; how that language applies to your advanced practice role is a question for a Texas employment attorney. If your contract was signed before September 1, 2025 and has not been renewed, ask your attorney which version of the law governs it.

Federal rule. The FTC's nationwide non-compete rule is not in effect. In September 2025 the Commission voted 3-1 to dismiss its appeals and accede to the vacatur of the rule, after a district court found that the FTC lacked the authority to issue it. The FTC says it will still go after specific non-competes case by case: the following week it sent warning letters to healthcare employers and staffing firms, stating that many of them may include unreasonable non-competes in contracts for nurses, physicians and other medical professionals. That is enforcement against individual agreements, not a ban, so review your non-compete against your own state's law with your attorney.

• Without cause: How many days' notice must each side give? Is it the same for you and the employer?
• For cause: Is "cause" defined with a specific list, or does it include vague terms like "conduct detrimental to the practice"?
• Cure period: Do you get written notice and time to fix a problem before termination for cause?
• Pay in lieu of notice: Can the employer end your employment immediately and pay out the notice period instead?
• What survives termination: Non-compete, repayment obligations, tail coverage and confidentiality. Check how each one changes depending on who ends the contract and why.

Find the clause that names the type of professional liability coverage. As HPSO explains, claims-made policies cover claims that occur and are reported while the policy is in force, and once the policy expires, coverage expires. Occurrence coverage applies if the incident occurred while the policy was in force, even after the policy ends.

• Is the policy claims-made or occurrence? What are the per-claim and aggregate limits?
• If claims-made, who pays for tail coverage, which extends the time alleged incidents may be reported after the policy ends?
• Does the answer change if you resign, are terminated without cause, or are terminated for cause?
• If you will rely on your next employer instead, does that employer offer prior acts coverage?
• Does the employer's policy cover you in every location and for every service the contract requires?

• How much CME money per year, and how many paid CME days? Are unused amounts lost?
• Does the employer pay your state license, DEA registration, board certification and hospital privileging fees?
• Are professional society dues covered?
• Does CME money have to be repaid if you leave mid-year?

For PAs, NCCPA certification maintenance requires 100 CME credits in every two-year cycle, so CME support has real value year after year.

Many states still require a formal relationship with a physician. AAPA notes that most state laws require PAs to have an agreement with a specific physician in order to practice, and AANP reports that reduced practice states require a career-long collaborative agreement and restricted practice states require career-long supervision, delegation or team management. The contract should say who fills that role and what happens if they leave.

• Who is your supervising or collaborating physician, and is a backup named?
• What does the arrangement require: chart review, co-signature, on-site time, meetings?
• If that physician leaves and no replacement is available, are you paid while you cannot practice?
• Are you charged any fee for supervision or collaboration?
• Does your scope in the contract match what your state allows and what you were told in the interview?

• Is call frequency stated in the contract, or left to future schedules?
• Is call from home or in house, and is it paid separately?
• How many patients per day or per shift are expected?
• Can the employer add locations or change your hours without your agreement?
• Is administrative time (inbox, charting, prior authorizations) built into the schedule?

• Assignment: Can the employer assign your contract to a buyer if the practice is sold? Does the non-compete follow the contract to the new owner?
• Term: How long is the initial term?
• Renewal: Does the contract renew automatically? In Texas, SB 1318 applies to covenants entered into or renewed on or after September 1, 2025, so a renewal date can matter.
• Amendments: Do changes require a written amendment signed by both sides?
• Dispute resolution: Is there an arbitration clause, and which state's law governs?

1. Mark every clause as fine, question or change.
2. Send the employer one email with your questions and requested changes.
3. Get every agreed change into the written contract, not a side email.
4. Have a healthcare employment attorney review the final version.
5. Keep a signed copy, and put renewal and notice deadlines on your calendar.