Registered Nurse 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).
Registered Nurse
RNs (general licensure, not an APRN) are not subject to a physician-supervision or collaborative-practice-agreement requirement in Virginia. § 54.1-3000 defines 'professional nursing' (RN) with no physician supervision/collaboration language, in explicit contrast to 'practical nursing' (LPN), which the statute defines as performed 'under the direction or supervision of a licensed medical practitioner, a professional nurse... or other licensed health professional.' Current Board of Nursing regs (18VAC90-19, successor to repealed 18VAC90-20) likewise impose supervision only on LPNs, not RNs.
Proximity
Not codified — left to the practice agreement
Chart review
Not codified — left to the practice agreement
Prescriptive authority
Covered by practice agreement · no controlled-substance authority
No RN prescriptive-authority provision exists in Virginia law; § 54.1-3000 only lets RNs administer medications 'as prescribed by any person authorized by law to prescribe.'Practice ownership (CPOM)
Non-licensee ownership permitted — General RN licensure does not require a healing-arts Professional Corporation (§ 13.1-543) or PLLC (§ 13.1-1102) in the first place — RNs (unlike APRNs) are not enumerated as an eligible owner under either statute, but also don't independently render the kind of licensed clinical services those statutes govern. Non-clinical businesses an RN might own (home health agency, staffing agency) fall under general Stock Corporation/LLC law, not the healing-arts regime, and carry no ownership restriction.
For medical-aesthetics (med-spa) businesses performing delegated medical procedures such as Botox or laser, RN ownership of the entity does not remove the requirement for physician delegation and oversight of the procedures themselves; ownership and clinical delegation authority are separate questions. The delegation regulation commonly cited for laser is 18VAC85-20-91; confirm it before relying on it.Supervision ratio
Not codified — left to the practice agreement
Meeting cadence
Not codified — left to the practice agreement
Written agreement
Not required
Unconditional — general RN licensure is never subject to physician supervision or a practice agreement in Virginia, unlike the APRN/PA categories above.Legal sources
18VAC90-19 — Regulations Governing the Practice of Nursing
$400–$600/mo
Estimated RN supervision cost in Virginia
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