PMHNP · Virginia
Supervision Agreement for Psychiatric Mental Health Nurse Practitioners in Virginia
Yes, a written supervising-physician agreement is required. Virginia does not name a specific instrument.
PMHNPs qualify for autonomous practice under the exact same § 54.1-2957 framework as general NPs — Virginia's only PMHNP-specific carve-out found in this research pass is the higher collaboration ratio below (18VAC90-40-90), not a separate independence pathway.
Independent practice requires: equivalent of ≥3 years full-time clinical experience — same 5,400-hour figure as general NP (1,800 hrs/year × 3, per 18VAC90-30-86; see that entry's note on the ≈4,500-hour figure some secondary sources repeat in error); attestation from a patient care team physician who supervised the experience, or (per H.B. 971, eff. 7/1/2024) an 'attesting nurse practitioner' who has held autonomous-practice status ≥3 years.
What the supervision 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)
Same standard as general NPs — no codified mile/minute radius or on-site requirement; practice agreement need only address availability for routine and urgent consultation (§ 54.1-2957, 18VAC90-40-90).
Supervision ratio
Up to 10 at a time
The one PMHNP-specific numeric rule found in Virginia code: up to 10 psychiatric-mental-health NPs per physician, vs. 6 for general NPs (18VAC90-40-90). NPs without prescriptive authority, and NPs who have already achieved autonomous-practice status, are not counted toward this 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
Same statutory scope as general NPs (Schedules II–VI, § 54.1-2957.01) — no PMHNP-specific schedule restriction found; autonomous-practice PMHNPs prescribe within their own scope without agreement-based restriction.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same as the general `np` entry — Professional Limited Liability Company (PLLC) under § 13.1-1102 (APRNs, which includes NP population foci such as PMHNP, are explicitly eligible independent owners), or a Professional Corporation under § 13.1-543.
What a supervising physician costs here
Typical monthly cost in Virginia
$500 – $650
Estimate for one Psychiatric Mental Health Nurse Practitioner. 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.