CNM · Virginia
Collaborative Practice Agreement for Certified Nurse-Midwives in Virginia
Yes, a written physician agreement is required. Virginia does not name a specific instrument.
Threshold enacted July 2021 (§ 54.1-2957(H)) — materially lower than the NP's ~3-year/5,400-hour threshold.
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.
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
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.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the 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.
Written agreement
Required
Practice ownership (corporate practice of medicine)
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.
Legal sources for these rules (3)
- Va. Code § 54.1-2957(H)secondary
- Va. Code § 54.1-2957.01secondary
- Virginia ACNM chapter — legislative trackingsecondary
What a collaborating physician costs here
Typical monthly cost in Virginia
$500 – $600
Estimate for one Certified Nurse-Midwife. Standard-tier state.
About Virginia's rules
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).
Other clinicians in Virginia: see the state overview.