A physician assistant that has sufficient education, training, and experience in the performance of an advanced duty, may perform that advanced duty under a collaboration agreement without Board approval if: The physician assistant is practicing at an exempt facility in accordance with Health Occupations Article, §15–302.1, Annotated Code of Maryland and meets the conditions in §A(4) of this regulation; The physician assistant has previously received Board approval to perform the advanced duty; or The physician assistant has at least 7,000 hours of clinical practice experience as attested to by the physician assistant. For a physician assistant practicing at an exempt facility the following shall be met: The patient care team physician listed on the collaboration agreement has been credentialed by the exempt facility as a condition of employment; The physician assistant listed on the collaboration agreement has been credentialed by the exempt facility as a condition of employment; and The advanced duty to be delegated by the patient care team physician to the physician assistant is reviewed and approved in a process approved by the exempt facility before the physician assistant performs the advanced duty. Except as provided under §A of this regulation, a physician assistant shall receive Board approval to perform an advanced duty prior to performing the advanced duty. A physician assistant performing X-Ray duties in accordance with Health Occupations Article, §14–306(e), Annotated Code of Maryland, shall: Notify the Board of an executed collaboration agreement in a manner approved by the Board; Maintain a copy of the collaboration agreement on file at the practice location; Obtain Board approval for the X-Ray duty as an advanced duty if practicing at a location other than an exempt facility; Perform the X-Ray duty in the medical office of a patient care team physician; and Be limited to nonfluoroscopic X-Ray procedures of the extremities, anterior-posterior and lateral, not including the head. In addition to the requirements of §C of this regulation, a physician assistant performing the advanced duty of nonfluoroscopic X-ray procedures using a mini C-arm or similar low-level radiation machine shall be required to present the Board with evidence of completion of a course that includes: Didactic instruction of at least eight hours on the following subject matters: Principles of radiography; Image acquisition; Principles of exposure; Image evaluation; Radiation safety; Equipment overview; and Documentation; and Clinical instruction, which shall: Include anterior-posterior and lateral radiographic studies of extremities, not including the head, on at least 20 separate patients; and Be under the direct supervision of the delegating physician or radiologist.