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Healthcare Recruiting

Virginia PA License 2026: Physician Assistant Requirements, OTP Authority, and Salary

AH
Ava Health Team
··8 min read

Virginia physician assistants practice under Optimal Team Practice (OTP) authority — no supervision agreement needs to be filed with the Virginia Board of Medicine. Northern Virginia's proximity to Washington DC, Richmond's academic health systems, and Hampton Roads' military-affiliated healthcare create three distinct PA employment corridors with different compensation profiles.

Practice Model: Optimal Team Practice (OTP)

  • No supervision agreement required to be filed with the Virginia Board of Medicine
  • Collaborative terms determined at the practice/employer level
  • Prescriptive authority for Schedule II–V included (DEA registration required separately)
  • Northern Virginia market reflects DC metro compensation premiums

Application Requirements

  • Active NCCPA certification
  • Accredited PA program graduation verification
  • Background check via Virginia DHP
  • Application fee ~$302

Processing Timeline

6–8 weeks typical; approximately 8 weeks total with concurrent DEA.

PA Salary in Virginia (2026)

SettingMedian BaseTypical Sign-On
Hospital / Inpatient (Northern Virginia)$130,000$10,000–$20,000
Hospital / Inpatient (Richmond)$122,000$8,000–$16,000
Surgical First-Assist$136,000$10,000–$22,000
Primary Care / Outpatient$115,000$5,000–$15,000

Top PA Employers in Virginia

Inova Health System (Northern Virginia — Fairfax and Falls Church, 5 hospitals, DC-adjacent premium market), VCU Health (Richmond academic flagship — Level I trauma, oncology), Sentara Healthcare (Norfolk/Hampton Roads — 12 hospitals), and Carilion Clinic (Roanoke — rural reach into SW Virginia) are the dominant systems. Rural Virginia carries HPSA loan repayment eligibility throughout Appalachian and Southside Virginia.

What We See at Ava Health

Virginia's three-corridor market means salary benchmarks vary widely. Northern Virginia commands DC-metro premiums with Inova's competitive packages. VCU's academic programs and Sentara's volume create strong Hampton Roads demand. Rural SW Virginia has persistent PA shortages with NHSC loan repayment eligibility.

Related: NP License Virginia 2026, PA Salary by State 2026, Healthcare Recruiting in Virginia 2026.

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