Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
Chapter 80. Methods and Standards for Establishing Payment Rate; Other Types of Care
5/30/2024

12VAC30-80-115. Fee-for-service: Early Discharge Follow-up Visit for Mothers and Newborns.

The early discharge follow-up visit for mothers and newborns covered under the provisions of 12VAC30-50-220 C shall be reimbursed at the lower of the state agency fee schedule or actual charges. Providers qualified for reimbursement of this service are those hospitals, physicians, nurse midwives, nurse practitioners, federally qualified health clinics, rural health clinics, and health department clinics that are enrolled as Medicaid providers and are qualified by the appropriate state authority for delivery of the service. The service shall be delivered either by the appropriate professional who is an employee of the participating provider or is under contract with the participating billing providers listed in this section. The staff providing the follow-up visit, at a minimum, shall be a registered nurse having training and experience in maternal and child health.

Statutory Authority

§ 32.1-325 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 13, Issue 1, eff. November 1, 1996.

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