                                 CODE OF VIRGINIA

DEFINITIONS (§ 54.1-2900)

As used in this chapter, unless the context requires a different meaning:
		&#8220;Acupuncturist&#8221; means an individual approved by the Board to
practice acupuncture. This is limited to &#8220;licensed acupuncturist&#8221;
which means an individual other than a doctor of medicine, osteopathy,
chiropractic or podiatry who has successfully completed the requirements for
licensure established by the Board (approved titles are limited to: Licensed
Acupuncturist, Lic.Ac., and L.Ac.).
		&#8220;Advanced practice registered nurse&#8221; means a certified nurse
midwife, certified registered nurse anesthetist, clinical nurse specialist, or
nurse practitioner who is jointly licensed by the Boards of Medicine and Nursing
pursuant to § 54.1-2957, has completed an advanced graduate-level education
program in a specialty category of nursing, and has passed a national certifying
examination for that specialty.
		&#8220;Auricular acupuncture&#8221; means the subcutaneous insertion of
sterile, disposable acupuncture needles in predetermined, bilateral locations in
the outer ear.
		&#8220;Birth control&#8221; means contraceptive methods that are approved by
the U.S. Food and Drug Administration. &#8220;Birth control&#8221; shall not be
considered abortion for the purposes of Title 18.2.
		&#8220;Board&#8221; means the Board of Medicine.
		&#8220;Certified nurse midwife&#8221; means an advanced practice registered
nurse who is certified in the specialty of nurse midwifery and who is jointly
licensed by the Boards of Medicine and Nursing as an advanced practice
registered nurse pursuant to § 54.1-2957.
		&#8220;Certified registered nurse anesthetist&#8221; means an advanced
practice registered nurse who is certified in the specialty of nurse anesthesia,
who is jointly licensed by the Boards of Medicine and Nursing as an advanced
practice registered nurse pursuant to § 54.1-2957, and who practices under the
supervision of a doctor of medicine, osteopathy, podiatry, or dentistry but is
not subject to the practice agreement requirement described in § 54.1-2957.
		&#8220;Clinical nurse specialist&#8221; means an advanced practice registered
nurse who is certified in the specialty of clinical nurse specialist and who is
jointly licensed by the Boards of Medicine and Nursing as an advanced practice
registered nurse pursuant to § 54.1-2957.
		&#8220;Collaboration&#8221; means the communication and decision-making
process among health care providers who are members of a patient care team
related to the treatment of a patient that includes the degree of cooperation
necessary to provide treatment and care of the patient and includes (i)
communication of data and information about the treatment and care of a patient,
including the exchange of clinical observations and assessments, and (ii)
development of an appropriate plan of care, including decisions regarding the
health care provided, accessing and assessment of appropriate additional
resources or expertise, and arrangement of appropriate referrals, testing, or
studies.
		&#8220;Consultation&#8221; means communicating data and information,
exchanging clinical observations and assessments, accessing and assessing
additional resources and expertise, problem-solving, and arranging for
referrals, testing, or studies.
		&#8220;Genetic counselor&#8221; means a person licensed by the Board to engage
in the practice of genetic counseling.
		&#8220;Healing arts&#8221; means the arts and sciences dealing with the
prevention, diagnosis, treatment and cure or alleviation of human physical or
mental ailments, conditions, diseases, pain or infirmities.
		&#8220;Licensed certified midwife&#8221; means a person who is licensed as a
certified midwife by the Boards of Medicine and Nursing.
		&#8220;Medical malpractice judgment&#8221; means any final order of any court
entering judgment against a licensee of the Board that arises out of any tort
action or breach of contract action for personal injuries or wrongful death,
based on health care or professional services rendered, or that should have been
rendered, by a health care provider, to a patient.
		&#8220;Medical malpractice settlement&#8221; means any written agreement and
release entered into by or on behalf of a licensee of the Board in response to a
written claim for money damages that arises out of any personal injuries or
wrongful death, based on health care or professional services rendered, or that
should have been rendered, by a health care provider, to a patient.
		&#8220;Nurse practitioner&#8221; means an advanced practice registered nurse,
other than an advanced practice registered nurse licensed by the Boards of
Medicine and Nursing in the category of certified nurse midwife, certified
registered nurse anesthetist, or clinical nurse specialist, who is jointly
licensed by the Boards of Medicine and Nursing pursuant to § 54.1-2957.
		&#8220;Occupational therapy assistant&#8221; means an individual who has met
the requirements of the Board for licensure and who works under the supervision
of a licensed occupational therapist to assist in the practice of occupational
therapy.
		&#8220;Patient care team&#8221; means a multidisciplinary team of health care
providers actively functioning as a unit with the management and leadership of
one or more patient care team physicians for the purpose of providing and
delivering health care to a patient or group of patients.
		&#8220;Patient care team physician&#8221; means a physician who is actively
licensed to practice medicine in the Commonwealth, who regularly practices
medicine in the Commonwealth, and who provides management and leadership in the
care of patients as part of a patient care team.
		&#8220;Patient care team podiatrist&#8221; means a podiatrist who is actively
licensed to practice podiatry in the Commonwealth, who regularly practices
podiatry in the Commonwealth, and who provides management and leadership in the
care of patients as part of a patient care team.
		&#8220;Physician assistant&#8221; means a health care professional who has met
the requirements of the Board for licensure as a physician assistant.
		&#8220;Practice of acupuncture&#8221; means the stimulation of certain points
on or near the surface of the body by the insertion of needles to prevent or
modify the perception of pain or to normalize physiological functions, including
pain control, for the treatment of certain ailments or conditions of the body
and includes the techniques of electroacupuncture, cupping, and moxibustion. The
practice of acupuncture does not include the use of physical therapy,
chiropractic, or osteopathic manipulative techniques; the use or prescribing of
any drugs, medications, serums or vaccines; or the procedure of the five needle
auricular acupuncture protocol (5NP) as exempted in § 54.1-2901.
		&#8220;Practice of athletic training&#8221; means the prevention, recognition,
evaluation, and treatment of injuries or conditions related to athletic or
recreational activity that requires physical skill and utilizes strength, power,
endurance, speed, flexibility, range of motion or agility or a substantially
similar injury or condition resulting from occupational activity immediately
upon the onset of such injury or condition; and subsequent treatment and
rehabilitation of such injuries or conditions, including in an inpatient or
outpatient setting, under the direction of the patient&#8217;s physician or
under the direction of any doctor of medicine, osteopathy, chiropractic,
podiatry, or dentistry, while using heat, light, sound, cold, electricity,
exercise or mechanical or other devices.
		&#8220;Practice of behavior analysis&#8221; means the design, implementation,
and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior,
including the use of direct observation, measurement, and functional analysis of
the relationship between environment and behavior.
		&#8220;Practice of chiropractic&#8221; means the adjustment of the 24 movable
vertebrae of the spinal column, and assisting nature for the purpose of
normalizing the transmission of nerve energy, but does not include the use of
surgery, obstetrics, osteopathy, or the administration or prescribing of any
drugs, medicines, serums, or vaccines. &#8220;Practice of chiropractic&#8221;
includes (i) requesting, receiving, and reviewing a patient&#8217;s medical and
physical history, including information related to past surgical and nonsurgical
treatment of the patient and controlled substances prescribed to the patient,
and (ii) documenting in a patient&#8217;s record information related to the
condition and symptoms of the patient, the examination and evaluation of the
patient made by the doctor of chiropractic, and treatment provided to the
patient by the doctor of chiropractic. &#8220;Practice of chiropractic&#8221;
further includes recommending or directing patients on the use of vitamins,
minerals, or food supplements. &#8220;Practice of chiropractic&#8221; also
includes performing the physical examination of an applicant for a commercial
driver&#8217;s license or commercial learner&#8217;s permit pursuant to §
46.2-341.12 if the practitioner has (a) applied for and received certification
as a medical examiner pursuant to 49 C.F.R. Part 390, Subpart D and (b)
registered with the National Registry of Certified Medical Examiners.
		&#8220;Practice of genetic counseling&#8221; means (i) obtaining and
evaluating individual and family medical histories to assess the risk of genetic
medical conditions and diseases in a patient, his offspring, and other family
members; (ii) discussing the features, history, diagnosis, environmental
factors, and risk management of genetic medical conditions and diseases; (iii)
ordering genetic laboratory tests and other diagnostic studies necessary for
genetic assessment; (iv) integrating the results with personal and family
medical history to assess and communicate risk factors for genetic medical
conditions and diseases; (v) evaluating the patient&#8217;s and family&#8217;s
responses to the medical condition or risk of recurrence and providing
client-centered counseling and anticipatory guidance; (vi) identifying and
utilizing community resources that provide medical, educational, financial, and
psychosocial support and advocacy; and (vii) providing written documentation of
medical, genetic, and counseling information for families and health care
professionals.
		&#8220;Practice of licensed certified midwifery&#8221; means the provision of
primary health care for preadolescents, adolescents, and adults within the scope
of practice of a certified midwife established in accordance with the Standards
for the Practice of Midwifery set by the American College of Nurse-Midwives,
including (i) providing sexual and reproductive care and care during pregnancy
and childbirth, postpartum care, and care for the newborn for up to 28 days
following the birth of the child; (ii) prescribing of pharmacological and
non-pharmacological therapies within the scope of the practice of midwifery;
(iii) consulting or collaborating with or referring patients to such other
health care providers as may be appropriate for the care of the patients; and
(iv) serving as an educator in the theory and practice of midwifery.
		&#8220;Practice of medicine or osteopathic medicine&#8221; means the
prevention, diagnosis, and treatment of human physical or mental ailments,
conditions, diseases, pain, or infirmities by any means or method.
		&#8220;Practice of occupational therapy&#8221; means the therapeutic use of
occupations for habilitation and rehabilitation to enhance physical health,
mental health, and cognitive functioning and includes the evaluation, analysis,
assessment, and delivery of education and training in basic and instrumental
activities of daily living; the design, fabrication, and application of orthoses
(splints); the design, selection, and use of adaptive equipment and assistive
technologies; therapeutic activities to enhance functional performance;
vocational evaluation and training; and consultation concerning the adaptation
of physical, sensory, and social environments.
		&#8220;Practice of podiatry&#8221; means the prevention, diagnosis, treatment,
and cure or alleviation of physical conditions, diseases, pain, or infirmities
of the human foot and ankle, including the medical, mechanical and surgical
treatment of the ailments of the human foot and ankle, but does not include
amputation of the foot proximal to the transmetatarsal level through the
metatarsal shafts. Amputations proximal to the metatarsal-phalangeal joints may
only be performed in a hospital or ambulatory surgery facility accredited by an
organization listed in § 54.1-2939. The practice includes the diagnosis and
treatment of lower extremity ulcers; however, the treatment of severe lower
extremity ulcers proximal to the foot and ankle may only be performed by
appropriately trained, credentialed podiatrists in an approved hospital or
ambulatory surgery center at which the podiatrist has privileges, as described
in § 54.1-2939. The Board of Medicine shall determine whether a specific type
of treatment of the foot and ankle is within the scope of practice of podiatry.
		&#8220;Practice of radiologic technology&#8221; means the application of
ionizing radiation to human beings for diagnostic or therapeutic purposes.
		&#8220;Practice of respiratory care&#8221; means the (i) administration of
pharmacological, diagnostic, and therapeutic agents related to respiratory care
procedures necessary to implement a treatment, disease prevention, pulmonary
rehabilitative, or diagnostic regimen prescribed by a practitioner of medicine
or osteopathic medicine; (ii) transcription and implementation of the written or
verbal orders of a practitioner of medicine or osteopathic medicine pertaining
to the practice of respiratory care; (iii) observation and monitoring of signs
and symptoms, general behavior, general physical response to respiratory care
treatment and diagnostic testing, including determination of whether such signs,
symptoms, reactions, behavior or general physical response exhibit abnormal
characteristics; and (iv) implementation of respiratory care procedures, based
on observed abnormalities, or appropriate reporting, referral, respiratory care
protocols or changes in treatment pursuant to the written or verbal orders by a
licensed practitioner of medicine or osteopathic medicine or the initiation of
emergency procedures, pursuant to the Board&#8217;s regulations or as otherwise
authorized by law. The practice of respiratory care may be performed in any
clinic, hospital, skilled nursing facility, private dwelling or other place
deemed appropriate by the Board in accordance with the written or verbal order
of a practitioner of medicine or osteopathic medicine, and shall be performed
under qualified medical direction.
		&#8220;Practice of surgical assisting&#8221; means the performance of
significant surgical tasks, including manipulation of organs, suturing of
tissue, placement of hemostatic agents, injection of local anesthetic,
harvesting of veins, implementation of devices, and other duties as directed by
a licensed doctor of medicine, osteopathy, or podiatry under the direct
supervision of a licensed doctor of medicine, osteopathy, or podiatry.
		&#8220;Qualified medical direction&#8221; means, in the context of the
practice of respiratory care, having readily accessible to the respiratory
therapist a licensed practitioner of medicine or osteopathic medicine who has
specialty training or experience in the management of acute and chronic
respiratory disorders and who is responsible for the quality, safety, and
appropriateness of the respiratory services provided by the respiratory
therapist.
		&#8220;Radiologic technologist&#8221; means an individual, other than a
licensed doctor of medicine, osteopathy, podiatry, or chiropractic or a dentist
licensed pursuant to Chapter 27 (§ 54.1-2700 et seq.), who (i) performs, may be
called upon to perform, or is licensed to perform a comprehensive scope of
diagnostic or therapeutic radiologic procedures employing ionizing radiation and
(ii) is delegated or exercises responsibility for the operation of
radiation-generating equipment, the shielding of patient and staff from
unnecessary radiation, the appropriate exposure of radiographs, the
administration of radioactive chemical compounds under the direction of an
authorized user as specified by regulations of the Department of Health, or
other procedures that contribute to any significant extent to the site or dosage
of ionizing radiation to which a patient is exposed.
		&#8220;Radiologic technologist, limited&#8221; means an individual, other than
a licensed radiologic technologist, dental hygienist, or person who is otherwise
authorized by the Board of Dentistry under Chapter 27 (§ 54.1-2700 et seq.) and
the regulations pursuant thereto, who performs diagnostic radiographic
procedures employing equipment that emits ionizing radiation that is limited to
specific areas of the human body.
		&#8220;Radiologist assistant&#8221; means an individual who has met the
requirements of the Board for licensure as an advanced-level radiologic
technologist and who, under the direct supervision of a licensed doctor of
medicine or osteopathy specializing in the field of radiology, is authorized to
(i) assess and evaluate the physiological and psychological responsiveness of
patients undergoing radiologic procedures; (ii) evaluate image quality, make
initial observations, and communicate observations to the supervising
radiologist; (iii) administer contrast media or other medications prescribed by
the supervising radiologist; and (iv) perform, or assist the supervising
radiologist to perform, any other procedure consistent with the guidelines
adopted by the American College of Radiology, the American Society of Radiologic
Technologists, and the American Registry of Radiologic Technologists.
		&#8220;Respiratory care&#8221; means the practice of the allied health
profession responsible for the direct and indirect services, including
inhalation therapy and respiratory therapy, in the treatment, management,
diagnostic testing, control, and care of patients with deficiencies and
abnormalities associated with the cardiopulmonary system under qualified medical
direction.
		&#8220;Surgical assistant&#8221; means an individual who has met the
requirements of the Board for licensure as a surgical assistant and who works
under the direct supervision of a licensed doctor of medicine, osteopathy, or
podiatry.

HISTORY: Code 1950, § 54-273; 1950, p. 110; 1958, c. 161; 1960, c. 268; 1966,
c. 657; 1970, c. 69; 1973, c. 529; 1975, cc. 508, 512; 1977, c. 127; 1980, c.
157; 1986, c. 439; 1987, cc. 522, 543; 1988, cc. 737, 765; 1991, c. 643; 1994,
c. 803; 1995, c. 777; 1996, cc. 152, 158, 470, 937, 980; 1998, cc. 319, 557,
593; 1999, cc. 639, 682, 747, 779; 2000, cc. 688, 814; 2001, c. 533; 2004, c.
731; 2007, c. 861; 2008, cc. 64, 89; 2009, cc. 83, 507; 2010, cc. 715, 725;
2011, cc. 121, 187; 2012, cc. 3, 110, 168, 213, 399; 2014, cc. 10, 266; 2015, c.
302; 2016, c. 93; 2017, c. 171; 2019, cc. 92, 137; 2020, cc. 357, 420, 1222;
2021, Sp. Sess. I, cc. 157, 200, 201; 2022, c. 151; 2023, c. 183; 2024, cc. 222,
548; 2025, cc. 184, 197.