Certified Nurse-Midwife 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).
Certified Nurse-Midwife
Independent practice requires: ≥1,000 hours of practice as a CNM; attestation from a CNM with ≥2 years of clinical experience, or from the licensed physician with whom the CNM held a qualifying practice agreement
Threshold enacted July 2021 (§ 54.1-2957(H)) — materially lower than the NP's ~3-year/5,400-hour threshold.
Proximity
Available remotely (no on-site requirement)
No codified mile/minute radius or on-site requirement; agreement need only address availability for routine and urgent consultation.Chart review
Not codified — left to the practice agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
May prescribe Schedules II–VI controlled substances/devices under § 54.1-2957.01; scope tied to the practice agreement until the 1,000-hour/attestation threshold is met, after which the CNM prescribes independently.Practice ownership (CPOM)
Licensee-only ownership required — Professional Limited Liability Company (PLLC) under § 13.1-1102 — CNMs, as an APRN category, are eligible independent PLLC owners; no physician ownership required. Alternatively a Professional Corporation under § 13.1-543 with all shares held by licensed/authorized individuals.
This ownership pathway is unaffected by whether the CNM has reached independent-practice status — the 1,000-hour/attestation threshold above governs clinical collaboration, not entity ownership.Supervision ratio
Not codified — left to the practice agreement
Meeting cadence
Not codified — left to the practice agreement
Written agreement
Required
$550–$850/mo
Estimated CNM supervision cost in Virginia
Available Supervising Physicians in Virginia
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