Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
9/19/2019

Chapter 50. Amount, Duration, and Scope of Medical and Remedial Care ServicesRead Chapter

Section 10
Services provided to the categorically needy with limitations
Section 20
Services provided to the categorically needy without limitation
Section 30
Services not provided to the categorically needy
Section 35
Requirements relating to payment for covered outpatient drugs for the categorically needy
Section 40
Ambulatory services
Section 50
Services provided to the medically needy with limitations
Section 60
Services provided to all medically needy groups without limitations
Section 70
Services or devices not provided to the medically needy
Section 75
Requirements relating to payment for covered outpatient drugs for the medically needy
Section 80
[Reserved]
Section 95
Reimbursement of services; in general
Section 100
Inpatient hospital services provided at general acute care hospitals and freestanding psychiatric hospitals; enrolled providers
Section 105
Inpatient hospital services provided at general acute care hospitals and freestanding psychiatric hospitals; nonenrolled providers ...
Section 110
Outpatient hospital and rural health clinic services
Section 120
Other laboratory and x-ray services
Section 130
Skilled nursing facility services, EPSDT, school health services and family planning
Section 131
Services provided by certified Early Intervention practitioners under EPSDT
Section 140
Physician's services whether furnished in the office, the patient's home, a hospital, a skilled nursing facility, or elsewhere
Section 150
Medical care by other licensed practitioners within the scope of their practice as defined by state law
Section 160
Home health services
Section 165
Durable medical equipment (DME) and supplies suitable for use in the home
Section 170
Private duty nursing services
Section 180
Clinic services
Section 190
Dental services
Section 200
Physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders
Section 210
Prescribed drugs, dentures, and prosthetic devices, and eyeglasses prescribed by a physician skilled in diseases of the eye or by an optometrist
Section 220
Diagnostic, screening, preventive, and rehabilitative services other than those provided elsewhere in this plan
Section 225
Rehabilitative services; intensive physical rehabilitation, and CORF services
Section 226
Community mental health services
Section 227
Lead contamination
Section 228
[Repealed]
Section 229
[Reserved]
Section 229.1
[Repealed]
Section 230
Services for individuals age 65 or older in institutions for mental diseases
Section 240
Intermediate care services and intermediate care services for institutions for mental disease and mental retardation
Section 250
Inpatient psychiatric facility services for individuals under 21 years of age
Section 260
Nurse-midwife services
Section 270
Hospice services (in accordance with § 1905 (o) of the Act)
Section 280
Case management services for high-risk pregnant women and children up to age 1, as defined in 12VAC30-50-410, in accordance with § 1915 (g)(1) of ...
Section 290
Extended services to pregnant women
Section 300
Any other medical care and any other type of remedial care recognized under state law, specified by the Secretary of Health and Human Services
Section 310
Emergency services for aliens
Section 320
Program of All-Inclusive Care for the Elderly (PACE)
Section 321
Eligibility for PACE enrollees
Section 325
Rates and payments
Section 328
PACE enrollment and disenrollment
Section 330
PACE definitions
Section 335
General PACE plan requirements
Section 340
Criteria for PACE enrollment
Section 345
PACE enrollee rights
Section 350
PACE enrollee responsibilities
Section 355
PACE plan contract requirements and standards
Section 360
PACE sanctions
Section 410
Case management services for high risk pregnant women and children
Section 415
Case management for individuals receiving early intervention (Part C) services
Section 420
Case management services for seriously mentally ill adults and emotionally disturbed children
Section 430
Case management services for youth at risk of serious emotional disturbance
Section 440
Case management services for individuals with mental retardation
Section 450
Case management services for individuals with mental retardation and related conditions who are participants in the Home and Community-Based Care ...
Section 460
[Repealed]
Section 470
Case management for recipients of auxiliary grants
Section 480
Case management for foster care children
Section 490
Case management for individuals with developmental disabilities, including autism
Section 491
Substance use case management services for individuals who have a primary diagnosis of substance use disorder
Section 510
Requirements and limits applicable to specific services: expanded prenatal care services
Section 520
Drugs or drug categories which are not covered
Section 530
Methods of providing transportation
Section 540
Kidney transplantation (KT)
Section 550
Corneal transplantation
Section 560
Liver, heart, lung, allogeneic and autologous bone marrow transplantation
Section 570
High dose chemotherapy and bone marrow/stem cell transplantation (coverage for persons over 21 years of age)
Section 580
Other medically necessary transplantation procedures that are determined to not be experimental or investigational (coverage for persons younger ...
Section 600
Section 1932 Medicare-Medicaid eligible individuals
FORMS
FORMS (12VAC30-50)
DIBR
DOCUMENTS INCORPORATED BY REFERENCE (12VAC30-50)

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