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Virginia Administrative Code
Title 12. Health
Title 12. Health
Agency 30. Department of Medical Assistance Services
11/21/2024

Chapter 80.
Methods and Standards for Establishing Payment Rate; Other Types of Care
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Section 10
General
Section 20
Services that are reimbursed on a cost basis
Section 21
Reimbursement for services furnished individuals residing in a freestanding psychiatric hospital or residential treatment center (Level C)
Section 25
Reimbursement for federally qualified health centers (FQHCs) and rural health clinics (RHCs)
Section 26
Reimbursement for Indian Health Service tribal 638 facilities
Section 30
Fee-for-service providers
Section 32
Reimbursement for substance use disorder services
Section 35
Fee for service: ambulatory surgery centers
Section 36
Fee-for-service providers: outpatient hospitals
Section 40
Fee-for-service providers: pharmacy
Section 50
Third party liability
Section 60
Reimbursement audit
Section 70
Fee-for-service providers: Transportation
Section 75
Local Education Agency (LEA) providers
Section 80
Fee-for-service: Medicare coinsurance and deductibles
Section 90
Fee-for-service: Eyeglasses
Section 95
Fee-for-service: hearing aids (under EPSDT)
Section 96
Fee-for-service: Early Intervention (under EPSDT)
Section 97
Fee-for-service: behavioral therapy services under EPSDT
Section 100
Fee-for-service: Expanded Prenatal Care
Section 110
Fee-for-service: case management
Section 111
Treatment foster care (TFC) case management
Section 115
Fee-for-service: Early Discharge Follow-up Visit for Mothers and Newborns
Section 120
Reimbursement for all other nonenrolled institutional and noninstitutional providers
Section 130
Refund of overpayments
Section 140
[Repealed]
Section 150
Dispute resolution for state-operated providers
Section 160
[Repealed]
Section 170
Payment of Medicare Part A and Part B Deductible/Coinsurance
Section 180
Establishment of rate per visit for home health services
Section 190
State agency fee schedule for RBRVS
Section 200
Prospective reimbursement for rehabilitation agencies or comprehensive outpatient rehabilitation facilities
Section 300
Medicare equivalent of average commercial rate
FORMS
FORMS (12VAC30-80)
DIBR
DOCUMENTS INCORPORATED BY REFERENCE (12VAC30-80)

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