How to Start a Chiropractic Practice in Virginia: $277 License, $312 Renewal, 30 CE Hours

October 29, 2026

If you want to start a chiropractic clinic in Virginia, the order of work matters. Your license comes first, because you cannot practice without it. Your business entity comes second, and the lease and equipment come after that. This guide follows that order and covers the Virginia chiropractic license fee, exam requirements, renewal schedule, continuing education rules, entity choices, and local items. Use it as a working checklist for how to open a chiropractic practice in Virginia, not as a replacement for the official rules.

Chiropractors are licensed by the Board of Medicine, which sits within the Department of Health Professions, under 18VAC85-20. Steps 1 through 4 below come from that chapter and its fee section.

Informational content only. This article is not legal, tax or licensing advice. Requirements, fees and deadlines can change. Confirm every figure with the agency named in this article before you pay or sign anything, and consult a qualified Virginia health care attorney and a CPA about your situation.

What You Need Before You Start

Gather these items before you start any application or filing:

• Official transcripts from your chiropractic program
• Official NBCE score reports for each exam part you have taken
• Government-issued photo ID and documents for any name change
• Names, addresses and contact details for any prior licensing boards
• Payment for the $277 application fee
• A short list of business names, checked in the SCC business search at cis.scc.virginia.gov
• A planning worksheet with your target city or county, expected space, equipment list and insurance quotes
• An EIN from the IRS once you know your entity type

Step 1: Apply for Your Virginia Chiropractic License

The Board of Medicine handles chiropractic licensure. Apply through the online licensing site run by the Department of Health Professions. Read 18VAC85-20 before you start, because the regulation sets eligibility and the Board decides your application.

1. Confirm eligibility. Compare the regulation to your education and exam history. A mismatch here is one of the most avoidable reasons an application stalls.
2. Create your application. Use the Department of Health Professions licensing site and complete every section. Partial applications wait in the queue.
3. Request your records. Have transcripts and exam scores sent in the form the application instructions require. Allow time for schools and the testing organization to respond.
4. Pay the $277 application fee. This is the application fee for chiropractic licensure under 18VAC85-20-22.
5. Track status and answer quickly. Check the application in the portal and reply to any document request the day it arrives.

Step 2: Meet the Exam and Education Requirements

If you graduated after January 31, 1996, the Board requires that you have passed Parts I, II, III and IV of the National Board of Chiropractic Examiners (NBCE) exam under 18VAC85-20-140. Confirm this before you apply, because a missing part will hold up your file.

The January 31, 1996 date is the dividing line in 18VAC85-20-140, so check your graduation date against that exact day. Your transcript and score reports should match what the Board will see.

Examination fees are set by and paid to the testing organization, not the state. Check the NBCE for current costs and scheduling. This article does not list exam prices or pass marks.

Step 3: Plan for the Fees and Virginia Chiropractic License Renewal

These are the fees listed in 18VAC85-20-22. Put them in your budget and on your calendar before you sign a lease.

Item	Amount	When it applies
Application for chiropractic licensure	$277	When you apply
Biennial renewal	$312	Each even-numbered year, in your birth month
Late renewal processing within one cycle	$105	If you renew late, within one cycle
Reinstatement of a license expired two years or more	$472	Includes the $367 reinstatement fee and the $105 late fee

Your renewal is due in your birth month in each even-numbered year. Set a calendar reminder well before that month, and renew on time. A late renewal adds the $105 processing fee, and letting the license expire for two years or more pushes the cost to $472.

Step 4: Complete Virginia Chiropractic Continuing Education

Under 18VAC85-20-235, each renewal cycle requires 30 hours of Type 1 clinical continuing education. Your first renewal is exempt. The requirement applies per renewal cycle, not per year, so do not budget it as a fixed yearly number. Keep your CE records for 6 years.

1. Know your first-renewal exemption. Your first renewal does not require the 30 hours, so start tracking with the cycle that follows.
2. Choose Type 1 clinical courses. Confirm each course counts as Type 1 clinical CE under 18VAC85-20-235 before you pay for it.
3. Log hours as you finish them. A simple spreadsheet with course title, provider, date, hours and certificate location is enough.
4. Keep certificates for six years. Store digital copies in a second location, not only on one laptop.

The most common mistake is treating continuing education as something to finish in renewal month. Spread the hours across the cycle so you are not rushing into courses at the last minute.

Step 5: Choose the Right Practice Entity

Your entity is the legal business that owns the practice. Under Va. Code 13.1-543, 13.1-544, 13.1-1102 and 13.1-1103, a professional corporation or professional limited liability company must have members licensed in the same profession. Plan your ownership structure with that rule in mind.

The State Corporation Commission (SCC) forms entities. It does not issue business licenses. Use the SCC Clerk's Information System at cis.scc.virginia.gov for name checks and online filing.

1. Reserve a name if you need time. A name reservation costs $10 and holds the name for 120 days.
2. Use a compliant LLC name. The name must contain 'limited company', 'limited liability company', 'LC', 'L.C.', 'LLC' or 'L.L.C.' and be distinguishable from names already on file.
3. Choose your filing path. The Articles of Organization for a Virginia LLC (Form LLC1011) cost $100. For a professional corporation or professional LLC, check the articles fee with the State Corporation Commission before you file.
4. Appoint a qualifying registered agent. The agent must be a Virginia resident with a Virginia street address, available during business hours, and either a Virginia State Bar member or a member, manager, officer, trustee or general partner of the entity. An entity cannot be its own agent.
5. Plan the annual fee. A Virginia LLC pays a $50 annual registration fee to the SCC and files no annual report. Stock corporations pay based on authorized shares, so check the SCC annual fee schedule.
6. Register an assumed name if you need one. If you will operate under a name other than the entity's legal name, file an Assumed Name Certificate with the SCC for $10. This filing goes to the SCC, not the circuit court.

Online filings can be expedited. Next-day service costs $50 or $100 and requires submission by 2:00 PM Eastern, with a response by 4:00 PM the next business day. Same-day service costs $200 and requires submission by 10:00 AM Eastern, with a response by 4:00 PM. Expedited service is online only and nonrefundable.

Open question: Whether a plain LLC may render chiropractic services is unsettled. Ask a Virginia health care attorney before you choose a plain LLC for your practice. For a professional corporation or professional LLC, confirm the articles fee with the State Corporation Commission.

Step 6: Set Up the Office and Handle the Local Items

This step has the most moving parts. Many tasks can run at the same time, but sign the lease only after your zoning, insurance and local license answers are in.

1. Time the lease and build-out. Confirm zoning for a medical office with your locality before you sign. If a contractor will build out the space, confirm the contractor's Virginia contractor class matches the contract value. Since July 1, 2025, Class C covers contracts over $1,000 to under $30,000, Class B covers $30,000 to under $150,000, and Class A covers $150,000 or more.
2. Budget equipment with written quotes. Tables, adjusting equipment, furniture, computers and software vary widely by specialty and setup. This article does not give an equipment price range. Get itemized written quotes from vendors rather than relying on a general estimate.
3. If you will take X-rays, ask the Department of Health first. The Department of Health regulates radiation-producing equipment. Ask the Department of Health whether registration applies before you buy or install imaging equipment, and do not assume the office is exempt.
4. Get insurance quotes before you sign the lease. Compare malpractice and general liability coverage. Ask each carrier what it covers for your planned services and for any X-ray use.
5. Set up billing and insurance credentialing. Payers need time to credential a new provider and location. Start those applications early and keep a log of every submission and follow-up.
6. Cover general compliance basics. Build HIPAA privacy and security practices for patient records, and OSHA workplace safety basics for staff and treatment areas. These are general compliance items, not a complete compliance program.
7. Get an EIN. Apply to the IRS for an employer identification number for your entity. You will need it for payroll, bank accounts and some tax filings.
8. Budget staff wages at the Virginia minimum. The state minimum wage is $12.77 in 2026, $13.75 in 2027 and $15.00 in 2028.
9. Check sales tax on retail items. If the front desk sells taxable retail products, you may need to register with Virginia Tax. Confirm which items are taxable. The state sales tax base rate is 5.3% (state plus local), 6% in regional tax localities, 6.3% in eight localities and 7% in the Historic Triangle (James City County, Williamsburg and York County).
10. Ask your locality about the BPOL license tax. Virginia has no general statewide business license. The Business, Professional and Occupational License (BPOL) is a local license tax under Va. Code 58.1-3700 et seq., administered by each city or county, usually through the Commissioner of the Revenue. Not every locality levies a general license, and Va. Code 58.1-3704 allows a locality to levy none. Stafford, Rockingham, Bedford County, Washington County, Montgomery County, Louisa and Fluvanna are examples of localities without a general county license, and towns can displace the county tax. Ask your locality whether a chiropractic office is subject to BPOL, and confirm the rate and filing deadline it sets.

The statute also sets population-based floors. A locality with more than 50,000 people cannot require a license for gross receipts under $100,000. A locality with 25,000 to 50,000 people cannot require one for gross receipts under $50,000, and no floor applies to a locality under 25,000 people. Localities over 50,000 may waive the license for smaller businesses up to a ceiling that is cited as $200,000. Confirm that ceiling with your locality. Localities set their own rates and filing deadlines, so do not assume a rate from another city or county.

Tips and Common Mistakes to Avoid

• Budgeting from old fee numbers. Use $277 for the application and $312 for the biennial renewal, and confirm both with the Department of Health Professions before you pay.
• Misreading the NBCE cutoff. The cutoff is January 31, 1996. Check your graduation date against that exact day.
• Forming a professional entity with the wrong owners. A professional corporation or professional LLC requires members licensed in the same profession.
• Signing a lease before the local answers. Get zoning, BPOL and insurance answers first.
• Letting renewal slip. A late renewal costs $105 within one cycle, and reinstatement after two years or more costs $472.
• Assuming a plain LLC can render chiropractic services. That point is unsettled, so ask a Virginia health care attorney.
• Confusing the state and local systems. The SCC forms your business but issues no business license. Your locality handles BPOL.
• Relying on memory for CE. Keep records of every course for 6 years.

What Results to Expect

A new practice usually builds its patient base gradually. Results depend on location, payer mix, referral relationships, the services you offer and how the practice is run. This article does not promise income, patient volume or clinical outcomes.

When you describe your services, use hedged language such as 'may help' or 'is designed to support,' and avoid claims that care cures or prevents disease. FDA rules govern many health claims, so review your website, brochures and advertising with a qualified professional before you publish them.

Next Steps

Start with the license. Read 18VAC85-20, gather your records and apply through the Department of Health Professions licensing site. Then meet with a Virginia health care attorney about your entity and with a CPA about your tax setup. These official resources will help:

• State Corporation Commission, Clerk's Office: scc.virginia.gov/businesses
• SCC Clerk's Information System for name searches and online filing: cis.scc.virginia.gov
• Virginia Department of Taxation (Virginia Tax): tax.virginia.gov
• Virginia Small Business Development Center network: virginiasbdc.org
• SBA Richmond district office resources: sba.gov/district/richmond

This article is informational content, not legal or tax advice. Confirm all fees, deadlines and requirements with the agencies named above, and consult a qualified attorney and CPA before you form your practice.