Unless otherwise provided, the following fees shall not be refundable:

1. The initial application fee for a license, payable at the time application is filed, shall be $130.

2. The biennial fee for renewal of an active license shall be $135 and for renewal of an inactive license shall be $70, payable in each odd-numbered year in the birth month of the licensee.

3. The additional fee for late renewal of licensure within one renewal cycle shall be $50.

4. The fee for authorization to practice without a practice agreement shall be $100.

5. A restricted volunteer license issued pursuant to § 54.1-2951.3 of the Code of Virginia shall expire 12 months from the date of issuance and may be renewed without charge by receipt of a renewal application that verifies that the physician assistant continues to comply with provisions of § 54.1-2951.3 of the Code of Virginia.

5. 6. The fee for reinstatement of a license pursuant to § 54.1-2408.2 of the Code of Virginia shall be $2,000.

6. 7. The fee for reinstatement of a license that has been expired for a period of two years or more shall be $180.

7. 8. The fee for a duplicate license shall be $5.00, and the fee for a duplicate wall certificate shall be $15.

8. 9. The handling fee for a returned check or a dishonored credit card or debit card shall be $50.

9. 10. The fee for a letter of good standing or verification to another jurisdiction shall be $10.

10. 11. The fee for an application or for the biennial renewal of a restricted volunteer license pursuant to 18VAC85-50-61 shall be $35, due in the licensee's birth month. An additional fee for late renewal of licensure shall be $15 for each renewal cycle.

A. No person shall practice as a physician assistant in the Commonwealth of Virginia except as provided in this chapter.

B. Except as provided in §§ 54.1-2952 C and 54.1-2952.01 of the Code of Virginia, all services rendered by a physician assistant shall be performed only in accordance with a practice agreement with one or more doctors of medicine, osteopathy, or podiatry licensed by this board to practice in the Commonwealth.

If for any reason the a physician assistant required to practice with a practice agreement discontinues working with a patient care team physician or podiatrist, a new practice agreement shall be entered into in order for the physician assistant either to be reemployed by the same practitioner or to accept new employment with another patient care team physician or podiatrist.

A. Prior Except as provided in §§ 54.1-2951.1 E, 54.1-2952 C and 54.1-2952.01 of the Code of Virginia, prior to the initiation of and as a condition of practice, a physician assistant and one or more patient care team physicians or podiatrists shall enter into a written or electronic practice agreement that spells out the roles and functions of the physician assistant and is consistent with provisions of §§ 54.1-2951.1 and 54.1-2952 of the Code of Virginia.

1. Any such practice agreement shall take into account such factors as the physician assistant's level of competence, the number of patients, the types of illness treated by the physicians or podiatrists, the nature of the treatment, special procedures, and the nature of the physician's or podiatrist's availability in ensuring direct physician or podiatrist involvement at an early stage and regularly thereafter.

2. The practice agreement shall also provide an evaluation process for the physician assistant's performance, including a requirement specifying the time period, proportionate to the acuity of care and practice setting, within which the physicians or podiatrists shall review the record of services rendered by the physician assistant.

3. The practice agreement may include requirements for periodic site visits by licensees who supervise and direct the patient care team physicians or podiatrists to collaborate and consult with physician assistants who provide services at a location other than where the physicians or podiatrists regularly practice.

B. The board may require information regarding the degree of collaboration and consultation by the patient care team physicians or podiatrists. The board may also require a patient care team physician or podiatrist to document the physician assistant's competence in performing such tasks.

C. If the role of the physician assistant includes prescribing drugs and devices, the written practice agreement shall include those schedules and categories of drugs and devices that are within the scope of practice and proficiency of the patient care team physicians or podiatrists.

D. If the initial practice agreement did not include prescriptive authority, there shall be an addendum to the practice agreement for prescriptive authority.

E. If there are any changes in consultation and collaboration, authorization, or scope of practice, a revised practice agreement shall be entered into at the time of the change.

F. Physician assistants appointed as medical examiners pursuant to § 32.1-282 of the Code of Virginia may practice without a written or electronic practice agreement.

G. Physician assistants employed by (i) a hospital as defined by § 32.1-123 of the Code of Virginia, (ii) a state facility as defined by § 37.2-100 of the Code of Virginia, or (iii) a federally qualified health center designated by the Centers for Medicare and Medicaid Services may practice without a written or electronic practice agreement consistent with the requirements contained in § 54.1-2951.1 E of the Code of Virginia.

A. The Except as provided in §§ 54.1-2952 C and 54.1-2952.01 of the Code of Virginia, the physician assistant shall not render independent health care and shall:

1. Perform only those medical care services that are within the scope of the practice and proficiency of the patient care team physicians or podiatrists as prescribed in the physician assistant's practice agreement. When a physician assistant is working outside the scope of specialty of the patient care team physicians or podiatrists, the physician assistant's functions shall be limited to those areas not requiring specialized clinical judgment, unless a separate practice agreement has been executed for an alternate patient care team physician or podiatrist.

2. Prescribe only those drugs and devices identified in a written practice agreement which meets the requirements of § 54.1-2952.1 of the Code of Virginia and as allowed in Part V (18VAC85-50-130 et seq.) of this chapter.

3. Wear during the course of performing physician assistant duties identification showing clearly status as a physician assistant.

B. If, due to illness, vacation, or unexpected absence, a patient care team physician or podiatrist or alternate physician or podiatrist is unable to collaborate or consult with the physician assistant, such patient care team physician or podiatrist may temporarily delegate the responsibility to another doctor of medicine, osteopathic medicine, or podiatry.

Temporary coverage may not exceed four weeks unless special permission is granted by the board.

C. With respect to physician assistants employed by institutions, the following additional provisions shall apply:

1. No physician assistant may render care to a patient unless the physician or podiatrist responsible for that patient is available for collaboration and consultation with that physician assistant.

2. Any such practice agreement as described in subdivision A 1 of this section shall delineate the duties that the patient care team physician or podiatrist authorizes the physician assistant to perform.

D. Practice by a physician assistant in a hospital, including an emergency department, shall be in accordance with § 54.1-2952 of the Code of Virginia.

A. A physician assistant with a current, unrestricted license may qualify for practice without a practice agreement within a specific clinical specialty or practice area upon meeting the requirements of § 54.1-2952.01 of the Code of Virginia.

B. An applicant to practice without a practice agreement shall submit the following:

1. The fee specified in 18VAC85-50-35; and

2. An attestation from a physician licensed by the board which meets the requirements of § 54.1-2952.01 of the Code of Virginia. The applicant may submit attestations from more than one physician with whom the applicant practiced during the required three years of clinical experience, but all attestations must be submitted at the same time.

C. In the event that a physician assistant is unable to obtain the attestation required by subsection B of § 54.1-2952.01 of the Code of Virginia, the board may accept other evidence demonstrating that the physician assistant has met the requirements of subsection B of § 54.1-2952.01 of the Code of Virginia.

D. A physician assistant authorized by the board to practice without a practice agreement shall comply with all provisions of § 54.1-2952.01 of the Code of Virginia.

A. The approved drugs and devices which the physician assistant with prescriptive authority may prescribe, administer, or dispense manufacturer's professional samples shall be in accordance with provisions of § 54.1-2952.1 of the Code of Virginia:.

B. The Unless the physician assistant is authorized to practice without a practice agreement pursuant to § 54.1-2952.01 of the Code of Virginia, the physician assistant may prescribe only those categories of drugs and devices included in the practice agreement. The patient care team physician or podiatrist retains the authority to restrict certain drugs within these approved categories.

C. The physician assistant, pursuant to § 54.1-2952.1 of the Code of Virginia, shall only dispense manufacturer's professional samples or administer controlled substances in good faith for medical or therapeutic purposes within the course of his professional practice.

A. Each prescription for a Schedule II through V drug shall bear the name of the patient care team physician or podiatrist and of the physician assistant.

B. The physician assistant shall disclose to the patient that he is a licensed physician assistant,. and also Unless the physician assistant is authorized to practice without a practice agreement pursuant to § 54.1-2952.01 of the Code of Virginia, the physician assistant shall also disclose the name, address and telephone number of the patient care team physician or podiatrist. Such disclosure shall either be included on the prescription or be given in writing to the patient.