Virginia scope of practice for med spas

RN / NP scope for injectables in Virginia

A Virginia nurse practitioner can reach AUTONOMOUS PRACTICE, but only by meeting a statutory experience threshold; until then a written practice agreement with a named patient care team physician is mandatory.

• An advanced practice registered nurse requires a JOINT license from the Board of Medicine and the Board of Nursing, and it is unlawful to practice as one in the Commonwealth without it. Virginia does not treat advanced practice as a certification layered on a nursing license; it is its own joint license.

  Va. Code § 54.1-2957(B) · verified Sep 2, 2026

• ⚠️ AUTONOMY IS EARNED, NOT GRANTED WITH THE LICENSE. Every nurse practitioner who does not meet the requirements of subsection I SHALL maintain appropriate collaboration and consultation, evidenced in a WRITTEN OR ELECTRONIC PRACTICE AGREEMENT, with at least one patient care team physician. A nurse practitioner who does meet those requirements may practice without one.

  Va. Code § 54.1-2957(C) · verified Sep 2, 2026

• The threshold is measured in postgraduate clinical experience, and the statute defines that term: “clinical experience” means the postgraduate delivery of health care DIRECTLY TO PATIENTS pursuant to a practice agreement with a patient care team physician. Time spent outside such an agreement does not count toward the autonomy the agreement is a prerequisite for.

  Va. Code § 54.1-2957(A) · verified Sep 2, 2026

• Two further details a practice should know: collaboration and consultation between an APRN and a patient care team physician MAY BE PROVIDED THROUGH TELEMEDICINE, and physicians on a patient care team may require the APRN to carry professional liability insurance with limits equal to the statutory cap on damages. Certified registered nurse anesthetists are outside this regime and practice under the supervision of a licensed physician, podiatrist or dentist.

  Va. Code § 54.1-2957(C) · verified Sep 2, 2026