Physician duties · CRNA · Virginia
Signing for a Certified Registered Nurse Anesthetist in Virginia: what the physician takes on
The agreement is mandatory for the clinician, which makes its duties mandatory for you. Virginia does not name a specific instrument.
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).
What you take on as the physician
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Not codified — left to the agreement
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
Covered by the 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.
Written agreement
Required
Practice ownership (corporate practice of medicine)
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.
Legal sources for these rules (4)
- Va. Code § 54.1-2957
- Va. Code § 54.1-2957.01 — CRNA periprocedural Schedule II-VI prescriptive authority (S.B. 264, in effect since 2020; previously omitted from this entry's sources, which caused controlledSubstancesAllowed to be miscoded False)
- 18VAC90-30-121 — Practice of APRNs Licensed as Certified Registered Nurse Anesthetists
- AANA — Fact Sheet Concerning State Opt-Outs (updated July 2026 — confirms Virginia is NOT a CMS Medicare opt-out state)secondary
What physicians charge for this role
Typical monthly compensation in Virginia
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. 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.