{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/54.1-3303.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/54.1-3303.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/54.1-3303.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/54.1-3303.html"}],"law_id":85347,"edition_id":1,"section_id":85347,"structure_id":14382,"section_number":"54.1-3303","catch_line":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","history":"1983, c. 528, \u00a7 54-524.50:1; 1985, c. 336; 1988, c. 765; 1991, cc. 519, 524; 1992, c. 793; 1996, cc. 152, 158, 408; 1997, c. 806; 1998, c. 101; 1999, c. 745; 2000, cc. 882, 924; 2001, c. 465; 2003, c. 639; 2004, c. 744; 2006, c. 432; 2010, c. 74; 2015, cc. 32, 115; 2016, c. 86; 2017, cc. 58, 110; 2018, cc. 373, 380, 790; 2019, c. 335; 2020, c. 464; 2021, Sp. Sess. I, cc. 200, 201, 301, 302; 2023, c. 183; 2025, cc. 391, 408.","full_text":"A\n\nA prescription for a controlled substance may be issued only by a practitioner of medicine, osteopathy, podiatry, dentistry or veterinary medicine who is authorized to prescribe controlled substances, a licensed advanced practice registered nurse pursuant to § 54.1-2957.01, a licensed certified midwife pursuant to § 54.1-2957.04, a licensed physician assistant pursuant to § 54.1-2952.1, or a TPA-certified optometrist pursuant to Article 5 (§ 54.1-3222 et seq.) of Chapter 32.B\n\nA prescription shall be issued only to persons or animals with whom the practitioner has a bona fide practitioner-patient relationship or veterinarian-client-patient relationship. If a practitioner is providing expedited partner therapy consistent with the recommendations of the Centers for Disease Control and Prevention, then a bona fide practitioner-patient relationship shall not be required.\n\t\t\tA bona fide practitioner-patient relationship shall exist if the practitioner has (i) obtained or caused to be obtained a medical or drug history of the patient; (ii) provided information to the patient about the benefits and risks of the drug being prescribed; (iii) performed or caused to be performed an appropriate examination of the patient, either physically or by the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically; and (iv) initiated additional interventions and follow-up care, if necessary, especially if a prescribed drug may have serious side effects. Except in cases involving a medical emergency, the examination required pursuant to clause (iii) shall be performed by the practitioner prescribing the controlled substance, a practitioner who practices in the same group as the practitioner prescribing the controlled substance, or a consulting practitioner.\n\t\t\tA practitioner who has established a bona fide practitioner-patient relationship with a patient in accordance with the provisions of this subsection may prescribe Schedule II through VI controlled substances to that patient.\n\t\t\tA practitioner who has established a bona fide practitioner-patient relationship with a patient in accordance with the provisions of this subsection may prescribe Schedule II through VI controlled substances to that patient via telemedicine if such prescribing is in compliance with federal requirements for the practice of telemedicine and, in the case of the prescribing of a Schedule II through V controlled substance, the prescriber maintains a practice at a physical location in the Commonwealth or is able to make appropriate referral of patients to a licensed practitioner located in the Commonwealth in order to ensure an in-person examination of the patient when required by the standard of care.\n\t\t\tA prescriber may establish a bona fide practitioner-patient relationship for the purpose of prescribing Schedule II through VI controlled substances by an examination through face-to-face interactive, two-way, real-time communications services or store-and-forward technologies when all of the following conditions are met: (a) the patient has provided a medical history that is available for review by the prescriber; (b) the prescriber obtains an updated medical history at the time of prescribing; (c) the prescriber makes a diagnosis at the time of prescribing; (d) the prescriber conforms to the standard of care expected of in-person care as appropriate to the patient’s age and presenting condition, including when the standard of care requires the use of diagnostic testing and performance of a physical examination, which may be carried out through the use of peripheral devices appropriate to the patient’s condition; (e) the prescriber is actively licensed in the Commonwealth and authorized to prescribe; (f) if the patient is a member or enrollee of a health plan or carrier, the prescriber has been credentialed by the health plan or carrier as a participating provider and the diagnosing and prescribing meets the qualifications for reimbursement by the health plan or carrier pursuant to § 38.2-3418.16; (g) upon request, the prescriber provides patient records in a timely manner in accordance with the provisions of § 32.1-127.1:03 and all other state and federal laws and regulations; (h) the establishment of a bona fide practitioner-patient relationship via telemedicine is consistent with the standard of care, and the standard of care does not require an in-person examination for the purpose of diagnosis; and (i) the establishment of a bona fide practitioner patient relationship via telemedicine is consistent with federal law and regulations and any waiver thereof. Nothing in this paragraph shall apply to (1) a prescriber providing on-call coverage per an agreement with another prescriber or his prescriber’s professional entity or employer; (2) a prescriber consulting with another prescriber regarding a patient’s care; or (3) orders of prescribers for hospital out-patients or in-patients.\n\t\t\tFor purposes of this section, a bona fide veterinarian-client-patient relationship is one in which a veterinarian, another veterinarian within the group in which he practices, or a veterinarian with whom he is consulting has assumed the responsibility for making medical judgments regarding the health of and providing medical treatment to an animal as defined in § 3.2-6500, other than an equine as defined in § 3.2-6200, a group of agricultural animals as defined in § 3.2-6500, or bees as defined in § 3.2-4400, and a client who is the owner or other caretaker of the animal, group of agricultural animals, or bees has consented to such treatment and agreed to follow the instructions of the veterinarian. Evidence that a veterinarian has assumed responsibility for making medical judgments regarding the health of and providing medical treatment to an animal, group of agricultural animals, or bees shall include evidence that the veterinarian (A) has sufficient knowledge of the animal, group of agricultural animals, or bees to provide a general or preliminary diagnosis of the medical condition of the animal, group of agricultural animals, or bees; (B) has made an examination of the animal, group of agricultural animals, or bees, either physically or by the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically or has become familiar with the care and keeping of that species of animal or bee on the premises of the client, including other premises within the same operation or production system of the client, through medically appropriate and timely visits to the premises at which the animal, group of agricultural animals, or bees are kept; and (C) is available to provide follow-up care.C\n\nA prescription shall only be issued for a medicinal or therapeutic purpose in the usual course of treatment or for authorized research. A prescription not issued in the usual course of treatment or for authorized research is not a valid prescription. A practitioner who prescribes any controlled substance with the knowledge that the controlled substance will be used otherwise than for medicinal or therapeutic purposes shall be subject to the criminal penalties provided in § 18.2-248 for violations of the provisions of law relating to the distribution or possession of controlled substances.D\n\nNo prescription shall be filled unless a bona fide practitioner-patient-pharmacist relationship exists. A bona fide practitioner-patient-pharmacist relationship shall exist in cases in which a practitioner prescribes, and a pharmacist dispenses, controlled substances in good faith to a patient for a medicinal or therapeutic purpose within the course of his professional practice.\n\t\t\tIn cases in which it is not clear to a pharmacist that a bona fide practitioner-patient relationship exists between a prescriber and a patient, a pharmacist shall contact the prescribing practitioner or his agent and verify the identity of the patient and name and quantity of the drug prescribed.\n\t\t\tAny person knowingly filling an invalid prescription shall be subject to the criminal penalties provided in § 18.2-248 for violations of the provisions of law relating to the sale, distribution or possession of controlled substances.E\n\nNotwithstanding any provision of law to the contrary and consistent with recommendations of the Centers for Disease Control and Prevention or the Department of Health, a practitioner may prescribe Schedule VI antibiotics and antiviral agents to other persons in close contact with a diagnosed patient when (i) the practitioner meets all requirements of a bona fide practitioner-patient relationship, as defined in subsection B, with the diagnosed patient and (ii) in the practitioner’s professional judgment, the practitioner deems there is urgency to begin treatment to prevent the transmission of a communicable disease. In cases in which the practitioner is an employee of or contracted by the Department of Health or a local health department, the bona fide practitioner-patient relationship with the diagnosed patient, as required by clause (i), shall not be required.F\n\nA pharmacist may dispense a controlled substance pursuant to a prescription of an out-of-state practitioner of medicine, osteopathy, podiatry, dentistry, optometry, or veterinary medicine, an advanced practice registered nurse, or a physician assistant authorized to issue such prescription if the prescription complies with the requirements of this chapter and the Drug Control Act (§ 54.1-3400 et seq.).G\n\nA licensed advanced practice registered nurse who is authorized to prescribe controlled substances pursuant to § 54.1-2957.01 may issue prescriptions or provide manufacturers’ professional samples for controlled substances and devices as set forth in the Drug Control Act (§ 54.1-3400 et seq.) in good faith to his patient for a medicinal or therapeutic purpose within the scope of his professional practice.H\n\nA licensed physician assistant who is authorized to prescribe controlled substances pursuant to § 54.1-2952.1 may issue prescriptions or provide manufacturers’ professional samples for controlled substances and devices as set forth in the Drug Control Act (§ 54.1-3400 et seq.) in good faith to his patient for a medicinal or therapeutic purpose within the scope of his professional practice.I\n\nA TPA-certified optometrist who is authorized to prescribe controlled substances pursuant to Article 5 (§ 54.1-3222 et seq.) of Chapter 32 may issue prescriptions in good faith or provide manufacturers’ professional samples to his patients for medicinal or therapeutic purposes within the scope of his professional practice pursuant to § 54.1-3223, which shall be limited to (i) analgesics included on Schedule II controlled substances as defined in § 54.1-3448 of the Drug Control Act (§ 54.1-3400 et seq.) consisting of hydrocodone in combination with acetaminophen; (ii) oral analgesics included in Schedules III through VI, as defined in §§ 54.1-3450 and 54.1-3455 of the Drug Control Act (§ 54.1-3400 et seq.), which are appropriate to relieve ocular pain; (iii) other oral Schedule VI controlled substances, as defined in § 54.1-3455 of the Drug Control Act, appropriate to treat diseases and abnormal conditions of the human eye and its adnexa; (iv) topically applied Schedule VI drugs, as defined in § 54.1-3455 of the Drug Control Act; and (v) intramuscular administration of epinephrine for treatment of emergency cases of anaphylactic shock.J\n\nThe requirement for a bona fide practitioner-patient relationship shall be deemed to be satisfied by a member or committee of a hospital’s medical staff when approving a standing order or protocol for the administration of influenza vaccinations and pneumococcal vaccinations in a hospital in compliance with § 32.1-126.4.K\n\nNotwithstanding any other provision of law, a prescriber may authorize a registered nurse or licensed practical nurse to approve additional refills of a prescribed drug for no more than 90 consecutive days, provided that (i) the drug is classified as a Schedule VI drug; (ii) there are no changes in the prescribed drug, strength, or dosage; (iii) the prescriber has a current written protocol, accessible by the nurse, that identifies the conditions under which the nurse may approve additional refills; and (iv) the nurse documents in the patient’s chart any refills authorized for a specific patient pursuant to the protocol and the additional refills are transmitted to a pharmacist in accordance with the allowances for an authorized agent to transmit a prescription orally or by facsimile pursuant to subsection C of § 54.1-3408.01 and regulations of the Board.","order_by":null,"text":{"0":{"id":305760,"text":"A prescription for a controlled substance may be issued only by a practitioner of medicine, osteopathy, podiatry, dentistry or veterinary medicine who is authorized to prescribe controlled substances, a licensed advanced practice registered nurse pursuant to § 54.1-2957.01, a licensed certified midwife pursuant to § 54.1-2957.04, a licensed physician assistant pursuant to § 54.1-2952.1, or a TPA-certified optometrist pursuant to Article 5 (§ 54.1-3222 et seq.) of Chapter 32.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":305761,"text":"A prescription shall be issued only to persons or animals with whom the practitioner has a bona fide practitioner-patient relationship or veterinarian-client-patient relationship. If a practitioner is providing expedited partner therapy consistent with the recommendations of the Centers for Disease Control and Prevention, then a bona fide practitioner-patient relationship shall not be required.\n\t\t\tA bona fide practitioner-patient relationship shall exist if the practitioner has (i) obtained or caused to be obtained a medical or drug history of the patient; (ii) provided information to the patient about the benefits and risks of the drug being prescribed; (iii) performed or caused to be performed an appropriate examination of the patient, either physically or by the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically; and (iv) initiated additional interventions and follow-up care, if necessary, especially if a prescribed drug may have serious side effects. Except in cases involving a medical emergency, the examination required pursuant to clause (iii) shall be performed by the practitioner prescribing the controlled substance, a practitioner who practices in the same group as the practitioner prescribing the controlled substance, or a consulting practitioner.\n\t\t\tA practitioner who has established a bona fide practitioner-patient relationship with a patient in accordance with the provisions of this subsection may prescribe Schedule II through VI controlled substances to that patient.\n\t\t\tA practitioner who has established a bona fide practitioner-patient relationship with a patient in accordance with the provisions of this subsection may prescribe Schedule II through VI controlled substances to that patient via telemedicine if such prescribing is in compliance with federal requirements for the practice of telemedicine and, in the case of the prescribing of a Schedule II through V controlled substance, the prescriber maintains a practice at a physical location in the Commonwealth or is able to make appropriate referral of patients to a licensed practitioner located in the Commonwealth in order to ensure an in-person examination of the patient when required by the standard of care.\n\t\t\tA prescriber may establish a bona fide practitioner-patient relationship for the purpose of prescribing Schedule II through VI controlled substances by an examination through face-to-face interactive, two-way, real-time communications services or store-and-forward technologies when all of the following conditions are met: (a) the patient has provided a medical history that is available for review by the prescriber; (b) the prescriber obtains an updated medical history at the time of prescribing; (c) the prescriber makes a diagnosis at the time of prescribing; (d) the prescriber conforms to the standard of care expected of in-person care as appropriate to the patient’s age and presenting condition, including when the standard of care requires the use of diagnostic testing and performance of a physical examination, which may be carried out through the use of peripheral devices appropriate to the patient’s condition; (e) the prescriber is actively licensed in the Commonwealth and authorized to prescribe; (f) if the patient is a member or enrollee of a health plan or carrier, the prescriber has been credentialed by the health plan or carrier as a participating provider and the diagnosing and prescribing meets the qualifications for reimbursement by the health plan or carrier pursuant to § 38.2-3418.16; (g) upon request, the prescriber provides patient records in a timely manner in accordance with the provisions of § 32.1-127.1:03 and all other state and federal laws and regulations; (h) the establishment of a bona fide practitioner-patient relationship via telemedicine is consistent with the standard of care, and the standard of care does not require an in-person examination for the purpose of diagnosis; and (i) the establishment of a bona fide practitioner patient relationship via telemedicine is consistent with federal law and regulations and any waiver thereof. Nothing in this paragraph shall apply to (1) a prescriber providing on-call coverage per an agreement with another prescriber or his prescriber’s professional entity or employer; (2) a prescriber consulting with another prescriber regarding a patient’s care; or (3) orders of prescribers for hospital out-patients or in-patients.\n\t\t\tFor purposes of this section, a bona fide veterinarian-client-patient relationship is one in which a veterinarian, another veterinarian within the group in which he practices, or a veterinarian with whom he is consulting has assumed the responsibility for making medical judgments regarding the health of and providing medical treatment to an animal as defined in § 3.2-6500, other than an equine as defined in § 3.2-6200, a group of agricultural animals as defined in § 3.2-6500, or bees as defined in § 3.2-4400, and a client who is the owner or other caretaker of the animal, group of agricultural animals, or bees has consented to such treatment and agreed to follow the instructions of the veterinarian. Evidence that a veterinarian has assumed responsibility for making medical judgments regarding the health of and providing medical treatment to an animal, group of agricultural animals, or bees shall include evidence that the veterinarian (A) has sufficient knowledge of the animal, group of agricultural animals, or bees to provide a general or preliminary diagnosis of the medical condition of the animal, group of agricultural animals, or bees; (B) has made an examination of the animal, group of agricultural animals, or bees, either physically or by the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically or has become familiar with the care and keeping of that species of animal or bee on the premises of the client, including other premises within the same operation or production system of the client, through medically appropriate and timely visits to the premises at which the animal, group of agricultural animals, or bees are kept; and (C) is available to provide follow-up care.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":305762,"text":"A prescription shall only be issued for a medicinal or therapeutic purpose in the usual course of treatment or for authorized research. A prescription not issued in the usual course of treatment or for authorized research is not a valid prescription. A practitioner who prescribes any controlled substance with the knowledge that the controlled substance will be used otherwise than for medicinal or therapeutic purposes shall be subject to the criminal penalties provided in § 18.2-248 for violations of the provisions of law relating to the distribution or possession of controlled substances.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":305763,"text":"No prescription shall be filled unless a bona fide practitioner-patient-pharmacist relationship exists. A bona fide practitioner-patient-pharmacist relationship shall exist in cases in which a practitioner prescribes, and a pharmacist dispenses, controlled substances in good faith to a patient for a medicinal or therapeutic purpose within the course of his professional practice.\n\t\t\tIn cases in which it is not clear to a pharmacist that a bona fide practitioner-patient relationship exists between a prescriber and a patient, a pharmacist shall contact the prescribing practitioner or his agent and verify the identity of the patient and name and quantity of the drug prescribed.\n\t\t\tAny person knowingly filling an invalid prescription shall be subject to the criminal penalties provided in § 18.2-248 for violations of the provisions of law relating to the sale, distribution or possession of controlled substances.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":305764,"text":"Notwithstanding any provision of law to the contrary and consistent with recommendations of the Centers for Disease Control and Prevention or the Department of Health, a practitioner may prescribe Schedule VI antibiotics and antiviral agents to other persons in close contact with a diagnosed patient when (i) the practitioner meets all requirements of a bona fide practitioner-patient relationship, as defined in subsection B, with the diagnosed patient and (ii) in the practitioner’s professional judgment, the practitioner deems there is urgency to begin treatment to prevent the transmission of a communicable disease. In cases in which the practitioner is an employee of or contracted by the Department of Health or a local health department, the bona fide practitioner-patient relationship with the diagnosed patient, as required by clause (i), shall not be required.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"5":{"id":305765,"text":"A pharmacist may dispense a controlled substance pursuant to a prescription of an out-of-state practitioner of medicine, osteopathy, podiatry, dentistry, optometry, or veterinary medicine, an advanced practice registered nurse, or a physician assistant authorized to issue such prescription if the prescription complies with the requirements of this chapter and the Drug Control Act (§ 54.1-3400 et seq.).","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"6":{"id":305766,"text":"A licensed advanced practice registered nurse who is authorized to prescribe controlled substances pursuant to § 54.1-2957.01 may issue prescriptions or provide manufacturers’ professional samples for controlled substances and devices as set forth in the Drug Control Act (§ 54.1-3400 et seq.) in good faith to his patient for a medicinal or therapeutic purpose within the scope of his professional practice.","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F","next_prefix":"H"},"7":{"id":305767,"text":"A licensed physician assistant who is authorized to prescribe controlled substances pursuant to § 54.1-2952.1 may issue prescriptions or provide manufacturers’ professional samples for controlled substances and devices as set forth in the Drug Control Act (§ 54.1-3400 et seq.) in good faith to his patient for a medicinal or therapeutic purpose within the scope of his professional practice.","type":"section","prefixes":["H"],"prefix":"H","entire_prefix":"H","prefix_anchor":"H","level":1,"prior_prefix":"G","next_prefix":"I"},"8":{"id":305768,"text":"A TPA-certified optometrist who is authorized to prescribe controlled substances pursuant to Article 5 (§ 54.1-3222 et seq.) of Chapter 32 may issue prescriptions in good faith or provide manufacturers’ professional samples to his patients for medicinal or therapeutic purposes within the scope of his professional practice pursuant to § 54.1-3223, which shall be limited to (i) analgesics included on Schedule II controlled substances as defined in § 54.1-3448 of the Drug Control Act (§ 54.1-3400 et seq.) consisting of hydrocodone in combination with acetaminophen; (ii) oral analgesics included in Schedules III through VI, as defined in §§ 54.1-3450 and 54.1-3455 of the Drug Control Act (§ 54.1-3400 et seq.), which are appropriate to relieve ocular pain; (iii) other oral Schedule VI controlled substances, as defined in § 54.1-3455 of the Drug Control Act, appropriate to treat diseases and abnormal conditions of the human eye and its adnexa; (iv) topically applied Schedule VI drugs, as defined in § 54.1-3455 of the Drug Control Act; and (v) intramuscular administration of epinephrine for treatment of emergency cases of anaphylactic shock.","type":"section","prefixes":["I"],"prefix":"I","entire_prefix":"I","prefix_anchor":"I","level":1,"prior_prefix":"H","next_prefix":"J"},"9":{"id":305769,"text":"The requirement for a bona fide practitioner-patient relationship shall be deemed to be satisfied by a member or committee of a hospital’s medical staff when approving a standing order or protocol for the administration of influenza vaccinations and pneumococcal vaccinations in a hospital in compliance with § 32.1-126.4.","type":"section","prefixes":["J"],"prefix":"J","entire_prefix":"J","prefix_anchor":"J","level":1,"prior_prefix":"I","next_prefix":"K"},"10":{"id":305770,"text":"Notwithstanding any other provision of law, a prescriber may authorize a registered nurse or licensed practical nurse to approve additional refills of a prescribed drug for no more than 90 consecutive days, provided that (i) the drug is classified as a Schedule VI drug; (ii) there are no changes in the prescribed drug, strength, or dosage; (iii) the prescriber has a current written protocol, accessible by the nurse, that identifies the conditions under which the nurse may approve additional refills; and (iv) the nurse documents in the patient’s chart any refills authorized for a specific patient pursuant to the protocol and the additional refills are transmitted to a pharmacist in accordance with the allowances for an authorized agent to transmit a prescription orally or by facsimile pursuant to subsection C of § 54.1-3408.01 and regulations of the Board.","type":"section","prefixes":["K"],"prefix":"K","entire_prefix":"K","prefix_anchor":"K","level":1,"prior_prefix":"J"}},"ancestry":[{"id":14382,"edition_id":1,"name":"General Provisions","identifier":"1","label":"article","depth":4,"order_by":1,"parent_id":13496,"metadata":{},"date_created":"2026-06-26 03:47:57","date_modified":"2026-06-26 03:47:57","permalink":{"id":243095,"object_type":"structure","relational_id":14382,"identifier":"1","token":"54.1\/III\/33\/1","url":"\/54.1\/III\/33\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13496,"edition_id":1,"name":"Pharmacy","identifier":"33","label":"chapter","depth":3,"order_by":1,"parent_id":12758,"metadata":{},"date_created":"2026-06-26 03:45:04","date_modified":"2026-06-26 03:45:04","permalink":{"id":243093,"object_type":"structure","relational_id":13496,"identifier":"33","token":"54.1\/III\/33","url":"\/54.1\/III\/33\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12758,"edition_id":1,"name":"Professions and Occupations Regulated by Boards Within the Department of Health Professions","identifier":"III","label":"subtitle","depth":2,"order_by":1,"parent_id":12754,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":241105,"object_type":"structure","relational_id":12758,"identifier":"III","token":"54.1\/III","url":"\/54.1\/III\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12754,"edition_id":1,"name":"Professions and Occupations","identifier":"54.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":239313,"object_type":"structure","relational_id":12754,"identifier":"54.1","token":"54.1","url":"\/54.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":72064,"structure_id":14382,"section_number":"54.1-3300","catch_line":"Definitions","url":"\/54.1-3300\/","token":"54.1\/III\/33\/1\/54.1-3300","metadata":false},{"id":77902,"structure_id":14382,"section_number":"54.1-3300.1","catch_line":"Participation in collaborative agreements; regulations to be promulgated by the Boards of Medicine and Pharmacy","url":"\/54.1-3300.1\/","token":"54.1\/III\/33\/1\/54.1-3300.1","metadata":false},{"id":55719,"structure_id":14382,"section_number":"54.1-3301","catch_line":"Exceptions","url":"\/54.1-3301\/","token":"54.1\/III\/33\/1\/54.1-3301","metadata":false},{"id":68342,"structure_id":14382,"section_number":"54.1-3302","catch_line":"Restrictions on practitioners of the healing arts","url":"\/54.1-3302\/","token":"54.1\/III\/33\/1\/54.1-3302","metadata":false},{"id":85347,"structure_id":14382,"section_number":"54.1-3303","catch_line":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","url":"\/54.1-3303\/","token":"54.1\/III\/33\/1\/54.1-3303","metadata":false},{"id":86967,"structure_id":14382,"section_number":"54.1-3303.1","catch_line":"Initiating of treatment with and dispensing and administering of controlled substances by pharmacists","url":"\/54.1-3303.1\/","token":"54.1\/III\/33\/1\/54.1-3303.1","metadata":false},{"id":58623,"structure_id":14382,"section_number":"54.1-3304","catch_line":"Licensing of physicians to dispense drugs; renewals","url":"\/54.1-3304\/","token":"54.1\/III\/33\/1\/54.1-3304","metadata":false},{"id":68921,"structure_id":14382,"section_number":"54.1-3304.1","catch_line":"Authority to license and regulate practitioners; permits","url":"\/54.1-3304.1\/","token":"54.1\/III\/33\/1\/54.1-3304.1","metadata":false}],"previous_section":{"id":68342,"structure_id":14382,"section_number":"54.1-3302","catch_line":"Restrictions on practitioners of the healing arts","url":"\/54.1-3302\/","token":"54.1\/III\/33\/1\/54.1-3302","metadata":false},"next_section":{"id":86967,"structure_id":14382,"section_number":"54.1-3303.1","catch_line":"Initiating of treatment with and dispensing and administering of controlled substances by pharmacists","url":"\/54.1-3303.1\/","token":"54.1\/III\/33\/1\/54.1-3303.1","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/54.1-3303\/","history_text":"

This law was first created in 1983. The record of its establishment is cataloged in chapter 528 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1983 \u201cActs\u201d aren\u2019t available online. It has been modified 22 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1985, chapter 336; in 1988, chapter 765; in 1991, chapters 519 and 524; in 1992, chapter 793; in 1996, chapters 152<\/a>, 158<\/a>, and 408<\/a>; in 1997, chapter 806<\/a>; in 1998, chapter 101<\/a>; in 1999, chapter 745<\/a>; in 2000, chapters 882<\/a> and 924<\/a>; in 2001, chapter 465<\/a>; in 2003, chapter 639<\/a>; in 2004, chapter 744<\/a>; in 2006, chapter 432<\/a>; in 2010, chapter 74<\/a>; in 2015, chapters 32<\/a> and 115<\/a>; in 2016, chapter 86<\/a>; in 2017, chapters 58<\/a> and 110<\/a>; in 2018, chapters 373<\/a>, 380<\/a>, and 790<\/a>; in 2019, chapter 335<\/a>; in 2020, chapter 464<\/a>; in 2023, chapter 183<\/a>; in 2025, chapters 391<\/a> and 408<\/a>.<\/p>","references":[{"id":76872,"section_number":"32.1-122.03:1","catch_line":"Statewide Telehealth Plan","order_by":null,"url":"\/32.1-122.03_1\/"},{"id":74649,"section_number":"38.2-3407.6:1","catch_line":"Denial of benefits for certain prescription drugs prohibited","order_by":null,"url":"\/38.2-3407.6_1\/"},{"id":61286,"section_number":"38.2-3418.16","catch_line":"Coverage for telemedicine services","order_by":null,"url":"\/38.2-3418.16\/"},{"id":68394,"section_number":"54.1-2519","catch_line":"Definitions","order_by":null,"url":"\/54.1-2519\/"},{"id":72705,"section_number":"54.1-2522.1","catch_line":"(Effective July 1, 2027) Requirements of practitioners","order_by":null,"url":"\/54.1-2522.1\/"},{"id":56919,"section_number":"54.1-2523","catch_line":"Confidentiality of data; disclosure of information; discretionary authority of Director","order_by":null,"url":"\/54.1-2523\/"},{"id":77902,"section_number":"54.1-3300.1","catch_line":"Participation in collaborative agreements; regulations to be promulgated by the Boards of Medicine and Pharmacy","order_by":null,"url":"\/54.1-3300.1\/"},{"id":55719,"section_number":"54.1-3301","catch_line":"Exceptions","order_by":null,"url":"\/54.1-3301\/"},{"id":86967,"section_number":"54.1-3303.1","catch_line":"Initiating of treatment with and dispensing and administering of controlled substances by pharmacists","order_by":null,"url":"\/54.1-3303.1\/"},{"id":59669,"section_number":"54.1-3401","catch_line":"Definitions","order_by":null,"url":"\/54.1-3401\/"},{"id":77665,"section_number":"54.1-3408","catch_line":"Professional use by practitioners","order_by":null,"url":"\/54.1-3408\/"},{"id":68723,"section_number":"54.1-3408.01","catch_line":"Requirements for prescriptions","order_by":null,"url":"\/54.1-3408.01\/"},{"id":83740,"section_number":"54.1-3410","catch_line":"When pharmacist may sell and dispense drugs","order_by":null,"url":"\/54.1-3410\/"},{"id":84268,"section_number":"54.1-3410.2","catch_line":"Compounding; pharmacists' authority to compound under certain conditions; labeling and record maintenance requirements","order_by":null,"url":"\/54.1-3410.2\/"},{"id":77369,"section_number":"54.1-3434.1","catch_line":"Nonresident pharmacies to register with Board","order_by":null,"url":"\/54.1-3434.1\/"},{"id":74403,"section_number":"58.1-609.10","catch_line":"Miscellaneous exemptions","order_by":null,"url":"\/58.1-609.10\/"}],"refers_to":[{"id":68693,"section_number":"18.2-248","catch_line":"Manufacturing, selling, giving, distributing, or possessing with intent to manufacture, sell, give, or distribute a controlled substance or an imitation controlled substance prohibited; penalties","order_by":null,"url":"\/18.2-248\/"},{"id":66320,"section_number":"3.2-4400","catch_line":"Definitions","order_by":null,"url":"\/3.2-4400\/"},{"id":83863,"section_number":"3.2-6200","catch_line":"Definitions","order_by":null,"url":"\/3.2-6200\/"},{"id":86401,"section_number":"3.2-6500","catch_line":"Definitions","order_by":null,"url":"\/3.2-6500\/"},{"id":58930,"section_number":"32.1-127.1:03","catch_line":"Health records privacy","order_by":null,"url":"\/32.1-127.1_03\/"},{"id":61286,"section_number":"38.2-3418.16","catch_line":"Coverage for telemedicine services","order_by":null,"url":"\/38.2-3418.16\/"},{"id":70057,"section_number":"54.1-2952.1","catch_line":"Prescription of certain controlled substances and devices by licensed physician assistants","order_by":null,"url":"\/54.1-2952.1\/"},{"id":71447,"section_number":"54.1-2957.01","catch_line":"Prescription of certain controlled substances and devices by licensed advanced practice registered nurses","order_by":null,"url":"\/54.1-2957.01\/"},{"id":83986,"section_number":"54.1-2957.04","catch_line":"Licensure as a licensed certified midwife; practice as a licensed certified midwife; independent practice as a licensed certified midwife; use of title; required disclosures","order_by":null,"url":"\/54.1-2957.04\/"},{"id":54127,"section_number":"54.1-3222","catch_line":"TPA certification; certification for treatment of diseases or abnormal conditions with therapeutic pharmaceutical agents (TPAs)","order_by":null,"url":"\/54.1-3222\/"},{"id":58604,"section_number":"54.1-3223","catch_line":"Regulations relating to therapeutic pharmaceutical agents","order_by":null,"url":"\/54.1-3223\/"},{"id":77846,"section_number":"54.1-3400","catch_line":"Citation","order_by":null,"url":"\/54.1-3400\/"},{"id":68723,"section_number":"54.1-3408.01","catch_line":"Requirements for prescriptions","order_by":null,"url":"\/54.1-3408.01\/"},{"id":56998,"section_number":"54.1-3448","catch_line":"Schedule II","order_by":null,"url":"\/54.1-3448\/"},{"id":76280,"section_number":"54.1-3450","catch_line":"Schedule III","order_by":null,"url":"\/54.1-3450\/"},{"id":82814,"section_number":"54.1-3455","catch_line":"Schedule VI","order_by":null,"url":"\/54.1-3455\/"}],"permalink":{"id":243113,"object_type":"law","relational_id":85347,"identifier":"54.1-3303","token":"54.1\/III\/33\/1\/54.1-3303","url":"\/54.1-3303\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/54.1-3303\/","token":"54.1\/III\/33\/1\/54.1-3303","dublin_core":{"Title":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","Type":"Text","Format":"text\/html","Identifier":"\u00a7 54.1-3303","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> A prescription for a controlled substance may be issued only by a practitioner of medicine, osteopathy, podiatry, dentistry or veterinary medicine who is authorized to prescribe controlled substances, a licensed advanced practice registered nurse pursuant to § 54.1-2957.01<\/a>, a licensed certified midwife pursuant to § 54.1-2957.04<\/a>, a licensed physician assistant pursuant to § 54.1-2952.1<\/a>, or a TPA-certified optometrist pursuant to Article 5 (§ 54.1-3222<\/a> et seq.) of Chapter 32. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> A prescription shall be issued only to persons or animals with whom the practitioner has a bona fide practitioner-patient relationship or veterinarian-client-patient relationship. If a practitioner is providing expedited partner therapy consistent with the recommendations of the Centers for Disease Control and Prevention, then a bona fide practitioner-patient relationship shall not be required.\n\t\t\tA bona fide practitioner-patient relationship shall exist if the practitioner has (i) obtained or caused to be obtained a medical or drug history of the patient; (ii) provided information to the patient about the benefits and risks of the drug being prescribed; (iii) performed or caused to be performed an appropriate examination of the patient, either physically or by the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically; and (iv) initiated additional interventions and follow-up care, if necessary, especially if a prescribed drug may have serious side effects. Except in cases involving a medical emergency, the examination required pursuant to clause (iii) shall be performed by the practitioner prescribing the controlled substance, a practitioner who practices in the same group as the practitioner prescribing the controlled substance, or a consulting practitioner.\n\t\t\tA practitioner who has established a bona fide practitioner-patient relationship with a patient in accordance with the provisions of this subsection may prescribe Schedule II through VI controlled substances to that patient.\n\t\t\tA practitioner who has established a bona fide practitioner-patient relationship with a patient in accordance with the provisions of this subsection may prescribe Schedule II through VI controlled substances to that patient via telemedicine if such prescribing is in compliance with federal requirements for the practice of telemedicine and, in the case of the prescribing of a Schedule II through V controlled substance, the prescriber maintains a practice at a physical location in the Commonwealth or is able to make appropriate referral of patients to a licensed practitioner located in the Commonwealth in order<\/span> to ensure an in-person examination of the patient when required by the standard of care.\n\t\t\tA prescriber may establish a bona fide practitioner-patient relationship for the purpose of prescribing Schedule II through VI controlled substances by an examination through face-to-face interactive, two-way, real-time communications services or store-and-forward technologies when all of the following conditions are met: (a) the patient has provided a medical history that is available for review by the prescriber; (b) the prescriber obtains an updated medical history at the time of prescribing; (c) the prescriber makes a diagnosis at the time of prescribing; (d) the prescriber conforms to the standard of care expected of in-person care as appropriate to the patient’s age and presenting condition, including when the standard of care requires the use of diagnostic testing and performance of a physical examination, which may be carried out through the use of peripheral devices appropriate to the patient’s condition; (e) the prescriber is actively licensed in the Commonwealth and authorized to prescribe; (f) if the patient is a member or enrollee of a health plan or carrier, the prescriber has been credentialed by the health plan or carrier as a participating provider and the diagnosing and prescribing meets the qualifications for reimbursement by the health plan or carrier pursuant to § 38.2-3418.16<\/a>; (g) upon request, the prescriber provides patient records in a timely manner in accordance with the provisions of § 32.1-127.1:03<\/a> and all other state and federal laws<\/span> and regulations; (h) the establishment of a bona fide practitioner-patient relationship via telemedicine is consistent with the standard of care, and the standard of care does not require an in-person examination for the purpose of diagnosis; and (i) the establishment of a bona fide practitioner patient relationship via telemedicine is consistent with federal law<\/span> and regulations and any waiver<\/span> thereof. Nothing in this paragraph shall apply to (1) a prescriber providing on-call coverage per an agreement with another prescriber or his prescriber’s professional entity or employer; (2) a prescriber consulting with another prescriber regarding a patient’s care; or (3) orders<\/span> of prescribers for hospital out-patients or in-patients.\n\t\t\tFor purposes of this section, a bona fide veterinarian-client-patient relationship is one in which a veterinarian, another veterinarian within the group in which he practices, or a veterinarian with whom he is consulting has assumed the responsibility for making medical judgments<\/span> regarding the health of and providing medical treatment to an animal as defined in § 3.2-6500<\/a>, other than an equine as defined in § 3.2-6200<\/a>, a group of agricultural animals as defined in § 3.2-6500<\/a>, or bees as defined in § 3.2-4400<\/a>, and a client who is the owner or other caretaker of the animal, group of agricultural animals, or bees has consented to such treatment and agreed to follow the instructions of the veterinarian. Evidence<\/span> that a veterinarian has assumed responsibility for making medical judgments<\/span> regarding the health of and providing medical treatment to an animal, group of agricultural animals, or bees shall include evidence<\/span> that the veterinarian (A) has sufficient knowledge of the animal, group of agricultural animals, or bees to provide a general or preliminary diagnosis of the medical condition of the animal, group of agricultural animals, or bees; (B) has made an examination of the animal, group of agricultural animals, or bees, either physically or by the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically or has become familiar with the care and keeping of that species of animal or bee on the premises of the client, including other premises within the same operation or production system of the client, through medically appropriate and timely visits to the premises at which the animal, group of agricultural animals, or bees are kept; and (C) is available to provide follow-up care. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> A prescription shall only be issued for a medicinal or therapeutic purpose in the usual course of treatment or for authorized research. A prescription not issued in the usual course of treatment or for authorized research is not a valid prescription. A practitioner who prescribes any controlled substance with the knowledge that the controlled substance will be used otherwise than for medicinal or therapeutic purposes shall be subject to the criminal penalties provided in § 18.2-248<\/a> for violations of the provisions of law<\/span> relating to the distribution or possession<\/span> of controlled substances. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> No prescription shall be filled unless a bona fide practitioner-patient-pharmacist<\/span> relationship exists. A bona fide practitioner-patient-pharmacist<\/span> relationship shall exist in cases in which a practitioner prescribes, and a pharmacist<\/span> dispenses<\/span>, controlled substances in good faith to a patient for a medicinal or therapeutic purpose within the course of his professional practice.\n\t\t\tIn cases in which it is not clear to a pharmacist<\/span> that a bona fide practitioner-patient relationship exists between a prescriber and a patient, a pharmacist<\/span> shall contact the prescribing practitioner or his agent and verify the identity of the patient and name and quantity of the drug prescribed.\n\t\t\tAny person knowingly filling an invalid prescription shall be subject to the criminal penalties provided in § 18.2-248<\/a> for violations of the provisions of law<\/span> relating to the sale, distribution or possession<\/span> of controlled substances. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Notwithstanding any provision of law<\/span> to the contrary and consistent with recommendations of the Centers for Disease Control and Prevention or the Department of Health, a practitioner may prescribe Schedule VI antibiotics and antiviral agents to other persons in close contact with a diagnosed patient when (i) the practitioner meets all requirements of a bona fide practitioner-patient relationship, as defined in subsection B, with the diagnosed patient and (ii) in the practitioner’s professional judgment<\/span>, the practitioner deems there is urgency to begin treatment to prevent the transmission of a communicable disease. In cases in which the practitioner is an employee of or contracted by the Department of Health or a local health department, the bona fide practitioner-patient relationship with the diagnosed patient, as required by clause (i), shall not be required. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> A pharmacist<\/span> may dispense<\/span> a controlled substance pursuant to a prescription of an out-of-state practitioner of medicine, osteopathy, podiatry, dentistry, optometry, or veterinary medicine, an advanced practice registered nurse, or a physician assistant authorized to issue<\/span> such prescription if the prescription complies with the requirements of this chapter and the Drug Control Act (§ 54.1-3400<\/a> et seq.). <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/span> A licensed advanced practice registered nurse who is authorized to prescribe controlled substances pursuant to § 54.1-2957.01<\/a> may issue<\/span> prescriptions or provide manufacturers’ professional samples for controlled substances and devices as set forth in the Drug Control Act (§ 54.1-3400<\/a> et seq.) in good faith to his patient for a medicinal or therapeutic purpose within the scope of his professional practice. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

H.<\/span> A licensed physician assistant who is authorized to prescribe controlled substances pursuant to § 54.1-2952.1<\/a> may issue<\/span> prescriptions or provide manufacturers’ professional samples for controlled substances and devices as set forth in the Drug Control Act (§ 54.1-3400<\/a> et seq.) in good faith to his patient for a medicinal or therapeutic purpose within the scope of his professional practice. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

I.<\/span> A TPA-certified optometrist who is authorized to prescribe controlled substances pursuant to Article 5 (§ 54.1-3222<\/a> et seq.) of Chapter 32 may issue<\/span> prescriptions in good faith or provide manufacturers’ professional samples to his patients for medicinal or therapeutic purposes within the scope of his professional practice pursuant to § 54.1-3223<\/a>, which shall be limited to (i) analgesics included on Schedule II controlled substances as defined in § 54.1-3448<\/a> of the Drug Control Act (§ 54.1-3400<\/a> et seq.) consisting of hydrocodone in combination with acetaminophen; (ii) oral analgesics included in Schedules<\/span> III through VI, as defined in §§ 54.1-3450<\/a> and 54.1-3455<\/a> of the Drug Control Act (§ 54.1-3400<\/a> et seq.), which are appropriate to relieve ocular pain; (iii) other oral Schedule VI controlled substances, as defined in § 54.1-3455<\/a> of the Drug Control Act, appropriate to treat diseases and abnormal conditions of the human eye and its adnexa; (iv) topically applied Schedule VI drugs, as defined in § 54.1-3455<\/a> of the Drug Control Act; and (v) intramuscular administration of epinephrine for treatment of emergency cases of anaphylactic shock. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

J.<\/span> The requirement for a bona fide practitioner-patient relationship shall be deemed to be satisfied by a member or committee of a hospital’s medical staff when approving a standing order<\/span> or protocol for the administration of influenza vaccinations and pneumococcal vaccinations in a hospital in compliance with § 32.1-126.4<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

K.<\/span> Notwithstanding any other provision of law<\/span>, a prescriber may authorize a registered nurse or licensed practical nurse to approve additional refills of a prescribed drug for no more than 90 consecutive days, provided that (i) the drug is classified as a Schedule VI drug; (ii) there are no changes in the prescribed drug, strength, or dosage; (iii) the prescriber has a current written protocol, accessible by the nurse, that identifies the conditions under which the nurse may approve additional refills; and (iv) the nurse documents in the patient’s chart any refills authorized for a specific patient pursuant to the protocol and the additional refills are transmitted to a pharmacist<\/span> in accordance with the allowances for an authorized agent to transmit a prescription orally or by facsimile pursuant to subsection C of § 54.1-3408.01<\/a> and regulations of the Board<\/span>. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nPRESCRIPTIONS TO BE ISSUED AND DRUGS TO BE DISPENSED FOR MEDICAL OR THERAPEUTIC\nPURPOSES ONLY (\u00a7 54.1-3303)\n\nA. A prescription for a controlled substance may be issued only by a\npractitioner of medicine, osteopathy, podiatry, dentistry or veterinary medicine\nwho is authorized to prescribe controlled substances, a licensed advanced\npractice registered nurse pursuant to § 54.1-2957.01, a licensed certified\nmidwife pursuant to § 54.1-2957.04, a licensed physician assistant pursuant\nto § 54.1-2952.1, or a TPA-certified optometrist pursuant to Article 5\n(§ 54.1-3222 et seq.) of Chapter 32.\n\nB. A prescription shall be issued only to persons or animals with whom the\npractitioner has a bona fide practitioner-patient relationship or\nveterinarian-client-patient relationship. If a practitioner is providing\nexpedited partner therapy consistent with the recommendations of the Centers for\nDisease Control and Prevention, then a bona fide practitioner-patient\nrelationship shall not be required.\n\t\t\tA bona fide practitioner-patient relationship shall exist if the practitioner\nhas (i) obtained or caused to be obtained a medical or drug history of the\npatient; (ii) provided information to the patient about the benefits and risks\nof the drug being prescribed; (iii) performed or caused to be performed an\nappropriate examination of the patient, either physically or by the use of\ninstrumentation and diagnostic equipment through which images and medical\nrecords may be transmitted electronically; and (iv) initiated additional\ninterventions and follow-up care, if necessary, especially if a prescribed drug\nmay have serious side effects. Except in cases involving a medical emergency,\nthe examination required pursuant to clause (iii) shall be performed by the\npractitioner prescribing the controlled substance, a practitioner who practices\nin the same group as the practitioner prescribing the controlled substance, or a\nconsulting practitioner.\n\t\t\tA practitioner who has established a bona fide practitioner-patient\nrelationship with a patient in accordance with the provisions of this subsection\nmay prescribe Schedule II through VI controlled substances to that patient.\n\t\t\tA practitioner who has established a bona fide practitioner-patient\nrelationship with a patient in accordance with the provisions of this subsection\nmay prescribe Schedule II through VI controlled substances to that patient via\ntelemedicine if such prescribing is in compliance with federal requirements for\nthe practice of telemedicine and, in the case of the prescribing of a Schedule\nII through V controlled substance, the prescriber maintains a practice at a\nphysical location in the Commonwealth or is able to make appropriate referral of\npatients to a licensed practitioner located in the Commonwealth in order to\nensure an in-person examination of the patient when required by the standard of\ncare.\n\t\t\tA prescriber may establish a bona fide practitioner-patient relationship for\nthe purpose of prescribing Schedule II through VI controlled substances by an\nexamination through face-to-face interactive, two-way, real-time communications\nservices or store-and-forward technologies when all of the following conditions\nare met: (a) the patient has provided a medical history that is available for\nreview by the prescriber; (b) the prescriber obtains an updated medical history\nat the time of prescribing; (c) the prescriber makes a diagnosis at the time of\nprescribing; (d) the prescriber conforms to the standard of care expected of\nin-person care as appropriate to the patient’s age and presenting\ncondition, including when the standard of care requires the use of diagnostic\ntesting and performance of a physical examination, which may be carried out\nthrough the use of peripheral devices appropriate to the patient’s\ncondition; (e) the prescriber is actively licensed in the Commonwealth and\nauthorized to prescribe; (f) if the patient is a member or enrollee of a health\nplan or carrier, the prescriber has been credentialed by the health plan or\ncarrier as a participating provider and the diagnosing and prescribing meets the\nqualifications for reimbursement by the health plan or carrier pursuant to\n§ 38.2-3418.16; (g) upon request, the prescriber provides patient records\nin a timely manner in accordance with the provisions of § 32.1-127.1:03 and\nall other state and federal laws and regulations; (h) the establishment of a\nbona fide practitioner-patient relationship via telemedicine is consistent with\nthe standard of care, and the standard of care does not require an in-person\nexamination for the purpose of diagnosis; and (i) the establishment of a bona\nfide practitioner patient relationship via telemedicine is consistent with\nfederal law and regulations and any waiver thereof. Nothing in this paragraph\nshall apply to (1) a prescriber providing on-call coverage per an agreement with\nanother prescriber or his prescriber’s professional entity or employer;\n(2) a prescriber consulting with another prescriber regarding a patient’s\ncare; or (3) orders of prescribers for hospital out-patients or in-patients.\n\t\t\tFor purposes of this section, a bona fide veterinarian-client-patient\nrelationship is one in which a veterinarian, another veterinarian within the\ngroup in which he practices, or a veterinarian with whom he is consulting has\nassumed the responsibility for making medical judgments regarding the health of\nand providing medical treatment to an animal as defined in § 3.2-6500,\nother than an equine as defined in § 3.2-6200, a group of agricultural\nanimals as defined in § 3.2-6500, or bees as defined in § 3.2-4400,\nand a client who is the owner or other caretaker of the animal, group of\nagricultural animals, or bees has consented to such treatment and agreed to\nfollow the instructions of the veterinarian. Evidence that a veterinarian has\nassumed responsibility for making medical judgments regarding the health of and\nproviding medical treatment to an animal, group of agricultural animals, or bees\nshall include evidence that the veterinarian (A) has sufficient knowledge of the\nanimal, group of agricultural animals, or bees to provide a general or\npreliminary diagnosis of the medical condition of the animal, group of\nagricultural animals, or bees; (B) has made an examination of the animal, group\nof agricultural animals, or bees, either physically or by the use of\ninstrumentation and diagnostic equipment through which images and medical\nrecords may be transmitted electronically or has become familiar with the care\nand keeping of that species of animal or bee on the premises of the client,\nincluding other premises within the same operation or production system of the\nclient, through medically appropriate and timely visits to the premises at which\nthe animal, group of agricultural animals, or bees are kept; and (C) is\navailable to provide follow-up care.\n\nC. A prescription shall only be issued for a medicinal or therapeutic purpose in\nthe usual course of treatment or for authorized research. A prescription not\nissued in the usual course of treatment or for authorized research is not a\nvalid prescription. A practitioner who prescribes any controlled substance with\nthe knowledge that the controlled substance will be used otherwise than for\nmedicinal or therapeutic purposes shall be subject to the criminal penalties\nprovided in § 18.2-248 for violations of the provisions of law relating to\nthe distribution or possession of controlled substances.\n\nD. No prescription shall be filled unless a bona fide\npractitioner-patient-pharmacist relationship exists. A bona fide\npractitioner-patient-pharmacist relationship shall exist in cases in which a\npractitioner prescribes, and a pharmacist dispenses, controlled substances in\ngood faith to a patient for a medicinal or therapeutic purpose within the course\nof his professional practice.\n\t\t\tIn cases in which it is not clear to a pharmacist that a bona fide\npractitioner-patient relationship exists between a prescriber and a patient, a\npharmacist shall contact the prescribing practitioner or his agent and verify\nthe identity of the patient and name and quantity of the drug prescribed.\n\t\t\tAny person knowingly filling an invalid prescription shall be subject to the\ncriminal penalties provided in § 18.2-248 for violations of the provisions\nof law relating to the sale, distribution or possession of controlled\nsubstances.\n\nE. Notwithstanding any provision of law to the contrary and consistent with\nrecommendations of the Centers for Disease Control and Prevention or the\nDepartment of Health, a practitioner may prescribe Schedule VI antibiotics and\nantiviral agents to other persons in close contact with a diagnosed patient when\n(i) the practitioner meets all requirements of a bona fide practitioner-patient\nrelationship, as defined in subsection B, with the diagnosed patient and (ii) in\nthe practitioner’s professional judgment, the practitioner deems there is\nurgency to begin treatment to prevent the transmission of a communicable\ndisease. In cases in which the practitioner is an employee of or contracted by\nthe Department of Health or a local health department, the bona fide\npractitioner-patient relationship with the diagnosed patient, as required by\nclause (i), shall not be required.\n\nF. A pharmacist may dispense a controlled substance pursuant to a prescription\nof an out-of-state practitioner of medicine, osteopathy, podiatry, dentistry,\noptometry, or veterinary medicine, an advanced practice registered nurse, or a\nphysician assistant authorized to issue such prescription if the prescription\ncomplies with the requirements of this chapter and the Drug Control Act (§\n54.1-3400 et seq.).\n\nG. A licensed advanced practice registered nurse who is authorized to prescribe\ncontrolled substances pursuant to § 54.1-2957.01 may issue prescriptions or\nprovide manufacturers’ professional samples for controlled substances and\ndevices as set forth in the Drug Control Act (§ 54.1-3400 et seq.) in good\nfaith to his patient for a medicinal or therapeutic purpose within the scope of\nhis professional practice.\n\nH. A licensed physician assistant who is authorized to prescribe controlled\nsubstances pursuant to § 54.1-2952.1 may issue prescriptions or provide\nmanufacturers’ professional samples for controlled substances and devices\nas set forth in the Drug Control Act (§ 54.1-3400 et seq.) in good faith to\nhis patient for a medicinal or therapeutic purpose within the scope of his\nprofessional practice.\n\nI. A TPA-certified optometrist who is authorized to prescribe controlled\nsubstances pursuant to Article 5 (§ 54.1-3222 et seq.) of Chapter 32 may\nissue prescriptions in good faith or provide manufacturers’ professional\nsamples to his patients for medicinal or therapeutic purposes within the scope\nof his professional practice pursuant to § 54.1-3223, which shall be\nlimited to (i) analgesics included on Schedule II controlled substances as\ndefined in § 54.1-3448 of the Drug Control Act (§ 54.1-3400 et seq.)\nconsisting of hydrocodone in combination with acetaminophen; (ii) oral\nanalgesics included in Schedules III through VI, as defined in §§\n54.1-3450 and 54.1-3455 of the Drug Control Act (§ 54.1-3400 et seq.),\nwhich are appropriate to relieve ocular pain; (iii) other oral Schedule VI\ncontrolled substances, as defined in § 54.1-3455 of the Drug Control Act,\nappropriate to treat diseases and abnormal conditions of the human eye and its\nadnexa; (iv) topically applied Schedule VI drugs, as defined in § 54.1-3455\nof the Drug Control Act; and (v) intramuscular administration of epinephrine for\ntreatment of emergency cases of anaphylactic shock.\n\nJ. The requirement for a bona fide practitioner-patient relationship shall be\ndeemed to be satisfied by a member or committee of a hospital’s medical\nstaff when approving a standing order or protocol for the administration of\ninfluenza vaccinations and pneumococcal vaccinations in a hospital in compliance\nwith § 32.1-126.4.\n\nK. Notwithstanding any other provision of law, a prescriber may authorize a\nregistered nurse or licensed practical nurse to approve additional refills of a\nprescribed drug for no more than 90 consecutive days, provided that (i) the drug\nis classified as a Schedule VI drug; (ii) there are no changes in the prescribed\ndrug, strength, or dosage; (iii) the prescriber has a current written protocol,\naccessible by the nurse, that identifies the conditions under which the nurse\nmay approve additional refills; and (iv) the nurse documents in the\npatient’s chart any refills authorized for a specific patient pursuant to\nthe protocol and the additional refills are transmitted to a pharmacist in\naccordance with the allowances for an authorized agent to transmit a\nprescription orally or by facsimile pursuant to subsection C of §\n54.1-3408.01 and regulations of the Board.\n\nHISTORY: 1983, c. 528, \u00a7 54-524.50:1; 1985, c. 336; 1988, c. 765; 1991, cc.\n519, 524; 1992, c. 793; 1996, cc. 152, 158, 408; 1997, c. 806; 1998, c. 101;\n1999, c. 745; 2000, cc. 882, 924; 2001, c. 465; 2003, c. 639; 2004, c. 744;\n2006, c. 432; 2010, c. 74; 2015, cc. 32, 115; 2016, c. 86; 2017, cc. 58, 110;\n2018, cc. 373, 380, 790; 2019, c. 335; 2020, c. 464; 2021, Sp. Sess. I, cc. 200,\n201, 301, 302; 2023, c. 183; 2025, cc. 391, 408.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}