Administrative Code

Creating a Report: Check the sections you'd like to appear in the report, then use the "Create Report" button at the bottom of the page to generate your report. Once the report is generated you'll then have the option to download it as a pdf, print or email the report.

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

Chapter 130. Amount, Duration, and Scope of Selected ServicesRead Chapter

Section 10
Section 15
Section 20
Section 30
Section 40
Section 42
Section 50
Section 60
Section 70
Section 80
Section 90
Authorization for services
Section 100
Criteria for long-stay acute care hospital stays
Section 110
Documentation requirements
Section 120
Long-stay acute care hospital services
Section 130
Long-stay acute care hospital requirements
Section 140
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
Section 270
Section 280
Section 290
Scope and purpose
Section 300
Retrospective DUR
Section 310
Prospective DUR
Section 320
Criteria and standards for DUR
Section 330
Educational program
Section 335
Other interventions
Section 340
DUR Board
Section 350
DUR Committee
Section 360
Exemption of organized health care settings
Section 370
Section 380
Section 390
Section 400
Utilization review process
Section 410
Section 420
Medical quality assurance
Section 430
Section 440
Section 450
Patient assessment criteria
Section 460
Directions for applying the criteria
Section 470
Section 540
Section 550
Section 560
Section 565
Section 570
Section 580
Section 590
Section 600
Section 610
Purpose and scope
Section 620
Section 630
Section 730
Section 740
Section 750
Time frames for determining cost effectiveness
Section 760
Section 770
Section 780
Section 790
Information required of applicants and recipients
Section 800
Section 810
Client Medical Management Program for individuals
Section 820
Client Medical Management Program for providers
Section 850
Section 860
Section 870
Section 880
Section 890
Section 900
Section 910
Targeted case management for foster care children in treatment foster care (TFC) covered services
Section 920
Provider qualifications
Section 930
Organization and administration requirements
Section 940
Discharge from care
Section 950
Entries in case records
Section 1000
Pharmacy services prior authorization
Section 2000
Marketing requirements and restrictions
Section 3000
Section 3010
Section 3020
Section 3030
Section 5000
Addiction and recovery treatment services
Section 5010
Addiction and recovery treatment services; purpose
Section 5020
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 opioid 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 (12VAC30-130)

Website addresses provided in the Virginia Administrative Code to documents incorporated by reference are for the reader's convenience only, may not necessarily be active or current, and should not be relied upon. To ensure the information incorporated by reference is accurate, the reader is encouraged to use the source document described in the regulation.

As a service to the public, the Virginia Administrative Code is provided online by the Virginia General Assembly. We are unable to answer legal questions or respond to requests for legal advice, including application of law to specific fact. To understand and protect your legal rights, you should consult an attorney.