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Virginia Administrative Code
Title 12. Health
Title 12. Health
Agency 30. Department of Medical Assistance Services
12/4/2023

Chapter 130.
Amount, Duration and Scope of Selected Services
Read Chapter

  • Part III.
    Preadmission Screening and Annual Resident Review
    Read all
    • Section 140
    Definitions
    Section 150
    Persons subject to nursing home preadmission screening and identification of conditions of mental illness and mental retardation (Level I)
    Section 160
    Level II determination
    Section 170
    Categorical determinations
    Section 180
    Annual resident review
    Section 190
    Determinations and placement of individuals with MI or MR/RC
    Section 200
    PASARR evaluation criteria
    Section 210
    Specialized services
    Section 220
    Placement options
    Section 230
    Evaluating the need for NF services and NF level of care (PASARR/NF)
    Section 240
    Evaluating whether an individual with MI requires specialized services (PASARR/MI)
    Section 250
    Evaluating whether an individual with MR/RC requires specialized services (PASARR/MR)
    Section 260
    Appeals
  • Part XVI.
    Pharmacy Services Prior Authorization
    Read all
    • Section 1000
    Pharmacy services prior authorization
  • Part XX.
    Addiction and Recovery Treatment Services
    Read all
    • Section 5000
    Addiction and recovery treatment services
    Section 5010
    Addiction and recovery treatment services; purpose
    Section 5020
    Definitions
    Section 5030
    Eligible individuals
    Section 5040
    Covered services: requirements; limits; standards
    Section 5050
    Covered services: clinic services - opioid treatment program services
    Section 5060
    Covered services: clinic services - preferred office-based addiction treatment
    Section 5070
    Covered services: practitioner services - early intervention/screening brief intervention and referral to treatment (ASAM Level 0.5)
    Section 5080
    Covered services: outpatient services - physician services (ASAM Level 1.0)
    Section 5090
    Covered services: community based services - intensive outpatient services (ASAM Level 2.1)
    Section 5100
    Covered services: community based care - partial hospitalization services (ASAM Level 2.5)
    Section 5110
    Covered services: clinically managed low intensity residential services (ASAM Level 3.1)
    Section 5120
    Covered services: clinically managed population - specific high intensity residential service (ASAM Level 3.3)
    Section 5130
    Covered services: clinically managed high intensity residential services (adult) and clinically managed medium intensity residential services...
    Section 5140
    Covered services: medically monitored intensive inpatient services (adult) and medically monitored high intensity inpatient services (adolescent)...
    Section 5150
    Covered services: medically managed intensive inpatient services (ASAM Level 4.0)
    Section 5160
    Peer support services and family support partners: definitions
    Section 5170
    Peer support services and family support partners: service definitions
    Section 5180
    Peer support services and family support partners: medical necessity criteria
    Section 5190
    Peer support services and family support partners: provider and setting requirements
    Section 5200
    Peer support services and family support partners: documentation of required activities
    Section 5210
    Peer support services and family support partners: limitations and exclusions to service delivery
FORMS
FORMS (12VAC30-130)
DIBR
DOCUMENTS INCORPORATED BY REFERENCE (12VAC30-130)

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