PA · Virginia
Collaborative Practice Agreement for Physician Assistants in Virginia
Yes, a written physician agreement is required. Virginia calls it a Practice Agreement.
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).
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).
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. 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).
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.
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
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).
Written agreement
Required
Practice ownership (corporate practice of medicine)
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 (or APRN-owned, per the NP entry) entity. A PA-specific independent-ownership pathway is unresolved/unconfirmed in current statute — treat as an open item rather than a settled fact.
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.
Legal sources for these rules (5)
What a collaborating physician costs here
Typical monthly cost in Virginia
$500 – $600
Estimate for one Physician Assistant. This state's proximity rules add a small premium.
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.