Can a Virginia NP prescribe medication independently?

A Virginia NP can prescribe medication independently only if the NP has been approved for autonomous practice by the Virginia Board of Nursing and the Virginia Board of Medicine². Otherwise, prescribing must occur under a practice agreement with a patient care team physician, and that agreement must describe and govern the NP’s prescriptive authority¹.

For controlled substances, Virginia NPs may prescribe Schedules II–IV only to the extent authorized in the practice agreement or as permitted under autonomous practice; practice agreements may also restrict this authority³. When prescribing, NPs must disclose that they are licensed APRNs at the initial encounter and provide the name of the patient care team physician upon request⁴.

To obtain autonomous practice, an NP (other than a CNM, CRNA, or CNS) must submit the required fee and attestation and have the equivalent of three years of full-time clinical experience (defined as 1,800 hours per year) delivering care under a practice agreement².