                                 CODE OF VIRGINIA

EXCEPTIONS AND EXEMPTIONS GENERALLY (§ 54.1-2901)

A. The provisions of this chapter shall not prevent or prohibit:

   1. Any person entitled to practice his profession under any prior law on June
   24, 1944, from continuing such practice within the scope of the definition of
   his particular school of practice;

   2. Any person licensed to practice naturopathy prior to June 30, 1980, from
   continuing such practice in accordance with regulations promulgated by the
   Board;

   3. Any licensed advanced practice registered nurse from rendering care in
   accordance with the provisions of &#xA7;&#xA7; 54.1-2957 and 54.1-2957.01, any
   advanced practice registered nurse licensed by the Boards of Medicine and
   Nursing in the category of certified nurse midwife practicing pursuant to
   subsection H of &#xA7; 54.1-2957, or any advanced practice registered nurse
   licensed by the Boards of Medicine and Nursing in the category of clinical
   nurse specialist practicing pursuant to subsection J of &#xA7; 54.1-2957 when
   such services are authorized by regulations promulgated jointly by the Boards
   of Medicine and Nursing;

   4. Any registered professional nurse, licensed advanced practice registered
   nurse, graduate laboratory technician, or other technical personnel who have
   been properly trained from rendering care or services within the scope of
   their usual professional activities which shall include the taking of blood,
   the giving of intravenous infusions and intravenous injections, and the
   insertion of tubes when performed under the orders of a person licensed to
   practice medicine or osteopathy, an advanced practice registered nurse, or a
   physician assistant;

   5. Any dentist, pharmacist, or optometrist from rendering care or services
   within the scope of his usual professional activities;

   6. Any practitioner licensed or certified by the Board from delegating to
   personnel supervised by him, such activities or functions as are
   nondiscretionary and do not require the exercise of professional judgment for
   their performance and which are usually or customarily delegated to such
   persons by practitioners of the healing arts, if such activities or functions
   are authorized by and performed for such practitioners of the healing arts and
   responsibility for such activities or functions is assumed by such
   practitioners of the healing arts;

   7. The rendering of medical advice or information through telecommunications
   from a physician licensed to practice medicine in Virginia or an adjoining
   state, or from a licensed advanced practice registered nurse, to emergency
   medical personnel acting in an emergency situation;

   8. The domestic administration of family remedies;

   9. The giving or use of massages, steam baths, dry heat rooms, infrared heat,
   or ultraviolet lamps in public or private health clubs and spas;

   10. The manufacture or sale of proprietary medicines in this Commonwealth by
   licensed pharmacists or druggists;

   11. The advertising or sale of commercial appliances or remedies;

   12. The fitting by nonitinerant persons or manufacturers of artificial eyes,
   limbs or other apparatus or appliances or the fitting of plaster cast
   counterparts of deformed portions of the body by a nonitinerant bracemaker or
   prosthetist for the purpose of having a three-dimensional record of the
   deformity, when such bracemaker or prosthetist has received a prescription
   from a licensed physician, licensed advanced practice registered nurse, or
   licensed physician assistant directing the fitting of such casts and such
   activities are conducted in conformity with the laws of Virginia;

   13. Any person from the rendering of first aid or medical assistance in an
   emergency in the absence of a person licensed to practice medicine or
   osteopathy under the provisions of this chapter;

   14. The practice of the religious tenets of any church in the ministration to
   the sick and suffering by mental or spiritual means without the use of any
   drug or material remedy, whether gratuitously or for compensation;

   15. Any legally qualified out-of-state or foreign practitioner from meeting in
   consultation with legally licensed practitioners in this Commonwealth;

   16. Any practitioner of the healing arts licensed or certified and in good
   standing with the applicable regulatory agency in another state or Canada when
   that practitioner of the healing arts is in Virginia temporarily and such
   practitioner has been issued a temporary authorization by the Board from
   practicing medicine or the duties of the profession for which he is licensed
   or certified (i) in a summer camp or in conjunction with patients who are
   participating in recreational activities, (ii) while participating in
   continuing educational programs prescribed by the Board, or (iii) by rendering
   at any site any health care services within the limits of his license,
   voluntarily and without compensation, to any patient of any clinic which is
   organized in whole or in part for the delivery of health care services without
   charge as provided in &#xA7; 54.1-106;

   17. The performance of the duties of any active duty health care provider in
   active service in the army, navy, coast guard, marine corps, air force, space
   force, or public health service of the United States at any public or private
   health care facility while such individual is so commissioned or serving and
   in accordance with his official military duties;

   18. Any masseur, who publicly represents himself as such, from performing
   services within the scope of his usual professional activities and in
   conformance with state law;

   19. Any person from performing services in the lawful conduct of his
   particular profession or business under state law;

   20. Any person from rendering emergency care pursuant to the provisions of
   &#xA7; 8.01-225;

   21. Qualified emergency medical services personnel, when acting within the
   scope of their certification, and licensed health care practitioners, when
   acting within their scope of practice, from following Durable Do Not
   Resuscitate Orders issued in accordance with &#xA7; 54.1-2987.1 and Board of
   Health regulations, or licensed health care practitioners from following any
   other written order of a physician not to resuscitate a patient in the event
   of cardiac or respiratory arrest;

   22. Any commissioned or contract medical officer of the army, navy, coast
   guard or air force rendering services voluntarily and without compensation
   while deemed to be licensed pursuant to &#xA7; 54.1-106;

   23. Any person from engaging in the five needle auricular acupuncture protocol
   (5NP), a standardized five needle protocol wherein up to five needles are
   inserted into the external human ear to provide relief from the effects of
   behavioral health conditions, provided such person (i) has appropriate
   training in the 5NP, including training established by the National
   Acupuncture Detoxification Association or equivalent certifying body; (ii)
   does not use any letters, words, or insignia indicating or implying that the
   person is an acupuncturist; and (iii) makes no statements implying that his
   practice of the 5NP is licensed, certified, or otherwise overseen by the
   Commonwealth. Treatment utilizing the 5NP pursuant to this subdivision shall
   be strictly limited to the insertion of disposable, sterile acupuncture
   needles into the ear and only in compliance with the 5NP. The application or
   insertion of needles anywhere else on the body of another person by a person
   acting under the provisions of this subdivision shall be considered engaging
   in the practice of acupuncture without a license;

   24. Any employee of any assisted living facility who is certified in
   cardiopulmonary resuscitation (CPR) acting in compliance with the
   patient&#8217;s individualized service plan and with the written order of the
   attending physician not to resuscitate a patient in the event of cardiac or
   respiratory arrest;

   25. Any person working as a health assistant under the direction of a licensed
   medical or osteopathic doctor within the Department of Corrections, the
   Department of Juvenile Justice or local correctional facilities;

   26. Any employee of a school board, authorized by a prescriber and trained in
   the administration of insulin and glucagon, when, upon the authorization of a
   prescriber and the written request of the parents as defined in &#xA7; 22.1-1,
   assisting with the administration of insulin or administrating glucagon to a
   student diagnosed as having diabetes and who requires insulin injections
   during the school day or for whom glucagon has been prescribed for the
   emergency treatment of hypoglycemia;

   27. Any practitioner of the healing arts or other profession regulated by the
   Board from rendering free health care to an underserved population of Virginia
   who (i) does not regularly practice his profession in Virginia, (ii) holds a
   current valid license or certificate to practice his profession in another
   state, territory, district or possession of the United States, (iii)
   volunteers to provide free health care to an underserved area of the
   Commonwealth under the auspices of a publicly supported all volunteer,
   nonprofit organization that sponsors the provision of health care to
   populations of underserved people, (iv) files a copy of the license or
   certification issued in such other jurisdiction with the Board, (v) notifies
   the Board at least five business days prior to the voluntary provision of
   services of the dates and location of such service, and (vi) acknowledges, in
   writing, that such licensure exemption shall only be valid, in compliance with
   the Board&#8217;s regulations, during the limited period that such free health
   care is made available through the volunteer, nonprofit organization on the
   dates and at the location filed with the Board. The Board may deny the right
   to practice in Virginia to any practitioner of the healing arts whose license
   or certificate has been previously suspended or revoked, who has been
   convicted of a felony or who is otherwise found to be in violation of
   applicable laws or regulations. However, the Board shall allow a practitioner
   of the healing arts who meets the above criteria to provide volunteer services
   without prior notice for a period of up to three days, provided the nonprofit
   organization verifies that the practitioner has a valid, unrestricted license
   in another state;

   28. Any registered nurse, acting as an agent of the Department of Health, from
   obtaining specimens of sputum or other bodily fluid from persons in whom the
   diagnosis of active tuberculosis disease, as defined in &#xA7; 32.1-49.1, is
   suspected and submitting orders for testing of such specimens to the Division
   of Consolidated Laboratories or other public health laboratories, designated
   by the State Health Commissioner, for the purpose of determining the presence
   or absence of tubercle bacilli as defined in &#xA7; 32.1-49.1;

   29. Any physician of medicine or osteopathy or advanced practice registered
   nurse from delegating to a registered nurse under his supervision the
   screening and testing of children for elevated blood-lead levels when such
   testing is conducted (i) in accordance with a written protocol between the
   physician or advanced practice registered nurse and the registered nurse and
   (ii) in compliance with the Board of Health&#8217;s regulations promulgated
   pursuant to &#xA7;&#xA7; 32.1-46.1 and 32.1-46.2. Any follow-up testing or
   treatment shall be conducted at the direction of a physician or an advanced
   practice registered nurse;

   30. Any practitioner of one of the professions regulated by the Board of
   Medicine who is in good standing with the applicable regulatory agency in
   another state or Canada from engaging in the practice of that profession when
   the practitioner is in Virginia temporarily with an out-of-state athletic team
   or athlete for the duration of the athletic tournament, game, or event in
   which the team or athlete is competing;

   31. Any person from performing state or federally funded health care tasks
   directed by the consumer, which are typically self-performed, for an
   individual who lives in a private residence and who, by reason of disability,
   is unable to perform such tasks but who is capable of directing the
   appropriate performance of such tasks;

   32. Any practitioner of one of the professions regulated by the Board of
   Medicine who is in good standing with the applicable regulatory agency in
   another state from engaging in the practice of that profession in Virginia
   with a patient who is being transported to or from a Virginia hospital for
   care;

   33. Any doctor of medicine or osteopathy, physician assistant, or advanced
   practice registered nurse who would otherwise be subject to licensure by the
   Board who holds an active, unrestricted license in another state, the District
   of Columbia, or a United States territory or possession and who is in good
   standing with the applicable regulatory agency in that state, the District of
   Columbia, or that United States territory or possession who provides
   behavioral health services, as defined in &#xA7; 37.2-100, from engaging in
   the practice of his profession and providing behavioral health services to a
   patient located in the Commonwealth in accordance with the standard of care
   when (i) such practice is for the purpose of providing continuity of care
   through the use of telemedicine services as defined in &#xA7; 38.2-3418.16 and
   (ii) the practitioner has previously established a practitioner-patient
   relationship with the patient and has performed an in-person evaluation of the
   patient within the previous year. A practitioner who provides behavioral
   health services to a patient located in the Commonwealth through use of
   telemedicine services pursuant to this subdivision may provide such services
   for a period of no more than one year from the date on which the practitioner
   began providing such services to such patient;

   34. Any employee of a program licensed by the Department of Behavioral Health
   and Developmental Services who is certified in cardiopulmonary resuscitation
   from acting in compliance with a program participant&#8217;s valid written
   order not to resuscitate issued in accordance with &#xA7; 54.1-2987.1 if such
   valid written order not to resuscitate is included in the program
   participant&#8217;s individualized service plan; or

   35. Any doctor of medicine or osteopathy, physician assistant, respiratory
   therapist, occupational therapist, or advanced practice registered nurse who
   would otherwise be subject to licensure by the Board who holds an active,
   unrestricted license in another state or the District of Columbia and who is
   in good standing with the applicable regulatory agency in that state or the
   District of Columbia from engaging in the practice of that profession in the
   Commonwealth with a patient located in the Commonwealth when (i) such practice
   is for the purpose of providing continuity of care through the use of
   telemedicine services as defined in &#xA7; 38.2-3418.16 and (ii) the patient
   is a current patient of the practitioner with whom the practitioner has
   previously established a practitioner-patient relationship and the
   practitioner has performed an in-person examination of the patient within the
   previous 12 months.
   				For purposes of this subdivision, if such practitioner with whom the
   patient has previously established a practitioner-patient relationship is
   unavailable at the time in which the patient seeks continuity of care, another
   practitioner of the same subspecialty at the same practice group with access
   to the patient&#8217;s treatment history may provide continuity of care using
   telemedicine services until the practitioner with whom the patient has a
   previously established practitioner-patient relationship becomes available.
   For the purposes of this subdivision, &#8220;practitioner of the same
   subspecialty&#8221; means a practitioner who utilizes the same subspecialty
   taxonomy code designation for claims processing.
   				For the purposes of this subdivision, if a patient is (a) an enrollee of a
   health maintenance organization that contracts with a multispecialty group of
   practitioners, each of whom is licensed by the Board of Medicine, and (b) a
   current patient of at least one practitioner who is a member of the
   multispecialty group with whom such practitioner has previously established a
   practitioner-patient relationship and of whom such practitioner has performed
   an in-person examination within the previous 12 months, the patient shall be
   deemed to be a current patient of each practitioner in the multispecialty
   group with whom each such practitioner has established a practitioner-patient
   relationship.

B. Notwithstanding any provision of law or regulation to the contrary, military
medical personnel, as defined in &#xA7; 2.2-2001.4, while participating in a
program established by the Department of Veterans Services pursuant to &#xA7;
2.2-2001.4, may practice under the supervision of a licensed physician or
podiatrist or the chief medical officer of an organization participating in such
program, or his designee who is a licensee of the Board and supervising within
his scope of practice.

HISTORY: Code 1950, §§ 54-273, 54-274, 54-276 through 54-276.6; 1950, pp. 98,
110; 1954, c. 556; 1958, c. 161; 1960, c. 268; 1962, cc. 127, 394; 164, c. 317;
1966, c. 657; 1970, c. 69; 1973, cc. 105, 514, 529; 1975, cc. 508, 512; 1976, c.
15; 1977, c. 127; 1980, c. 157; 1981, c. 300; 1982, c. 220; 1985, cc. 303, 347,
372; 1986, cc. 377, 439; 1987, cc. 522, 543; 1988, c. 765; 1992, cc. 412, 414;
1994, c. 787; 1995, cc. 509, 777; 1996, cc. 775, 779, 937, 980; 1998, cc. 630,
803, 854; 1999, cc. 570, 814; 2000, cc. 688, 814; 2001, cc. 235, 237, 533; 2002,
c. 740; 2003, cc. 514, 519, 641; 2005, cc. 113, 926; 2006, c. 750; 2008, c. 674;
2010, c. 245; 2011, cc. 632, 811; 2012, c. 213; 2014, c. 8; 2016, cc. 74, 212,
418, 494, 495; 2018, cc. 69, 338, 776; 2021, Sp. Sess. I, c. 157; 2022, cc. 275,
709, 720, 753; 2023, cc. 150, 151, 183; 2024, cc. 548, 817.