Supervising Physician Cheat Sheet for Virginia
Requirements for Supervising Physician agreements in Virginia, plus a free agreement builder tailored to Virginia law.
Provider supervision requirements in Virginia
Updated 2026-08-12
Provided for educational and research purposes only — this is not legal advice. Laws and regulations change frequently, and this content may contain errors or omissions. Always confirm current requirements with a licensed attorney before relying on this for compliance decisions.
No provider type below has a codified chart-review percentage, countersignature rule, or numeric proximity radius — all are left to the practice agreement. CPOM (ownership) is governed by Title 13.1's PC/PLLC statutes, which explicitly list APRNs (NP/CRNA/CNM/CNS) as eligible independent owners but do not enumerate PAs — the PA ownership pathway is an inference from that omission, not a confirmed holding. Virginia has no independent corporate-practice-of-medicine common-law doctrine (a 1992 AG opinion, secondary-sourced only).
Physician Assistant
Independent practice requires: ≥3 years full-time clinical experience, defined as 1,800 hours/year (~5,400 hours total); attestation from one or more patient care team physicians/podiatrists who supervised that experience (attestations from multiple physicians may be aggregated)
Pathway created by § 54.1-2952.01 (H.B. 746, Acts 2026 c. 418); contingent on Board of Medicine implementing regulations — confirm current effective status before treating as live. Separately, PAs employed by a hospital (§ 32.1-123), a state facility (§ 37.2-100), or an FQHC may already practice without a written practice agreement under § 54.1-2951.1(E).
Proximity
Available remotely (no on-site requirement)
No codified mile/minute radius. Practice agreement must address 'the nature of the physician's or podiatrist's availability in ensuring direct involvement at an early stage and regularly thereafter,' and may include periodic site visits when the PA practices at a location separate from the supervising physician (18VAC85-50-101).Chart review
Not codified — left to the practice agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Practice agreement must specify which Schedule II–VI controlled substances/devices the PA is or is not authorized to prescribe; requires ≥35 hours of Board-approved pharmacology training (§ 54.1-2952.1).Practice ownership (CPOM)
Licensee-only ownership required — No Virginia statute enumerates PAs as an eligible independent owner of a healing-arts professional corporation (§ 13.1-543) or PLLC (§ 13.1-1102); practice ownership likely requires a physician-owned entity (or an APRN-owned one, see the NP entry)
The 2026 PA autonomous-practice pathway (§ 54.1-2952.01) removes the clinical practice-agreement requirement once qualified, but does not itself amend Title 13.1's entity-ownership rules — confirm whether an autonomous PA gains an independent ownership pathway before relying on this.Supervision ratio
Up to 6 at a time
No patient care team physician or podiatrist may collaborate/consult with more than 6 PAs at any one time (§ 54.1-2952). Not stated as combined with the separate NP cap.Meeting cadence
Not codified — left to the practice agreement
Written agreement
Required
$600–$900/mo
Estimated PA supervision cost in Virginia
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