Certified Registered Nurse Anesthetist 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 Registered Nurse Anesthetist
No autonomous-practice pathway exists for CRNAs in Virginia. § 54.1-2957 requires care under the supervision of a licensed physician, osteopath, podiatrist, or dentist; CRNAs are carved out of the standard practice-agreement framework used for NP/CNM/prescribing-CNS. Virginia law doesn't define 'supervision' with a numeric distance or on-site standard for CRNAs — undefined in the Virginia Code and 18VAC90-30-121. Confirmed NOT a CMS Medicare opt-out state per AANA's official state opt-out list (updated July 2026).
Proximity
Not codified — left to the practice agreement
Chart review
Not codified — left to the practice agreement
Prescriptive authority
Covered by practice agreement · controlled substances permitted
CRNA practice must also conform to AANA's Standards for Nurse Anesthesia Practice as incorporated by reference in 18VAC90-30.Practice ownership (CPOM)
Licensee-only ownership required — Professional Limited Liability Company (PLLC) under § 13.1-1102 — CRNAs, 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.
Supervision ratio
Not codified — left to the practice agreement
Meeting cadence
Not codified — left to the practice agreement
Written agreement
Required
Legal sources
$500–$700/mo
Estimated CRNA supervision cost in Virginia
Available Supervising Physicians in Virginia
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