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Code of Virginia
Title 38.2. Insurance
Chapter 34. Provisions Relating to Accident and Sickness Insurance
7/1/2025

§ 38.2-3408. Policy providing for reimbursement for services that may be performed by certain practitioners other than physicians. (2025 updated section)

A. If an accident and sickness insurance policy provides reimbursement for any service that may be legally performed by a person licensed in this Commonwealth as a chiropractor, optometrist, optician, professional counselor, psychologist, clinical social worker, podiatrist, physical therapist, chiropodist, clinical nurse specialist, audiologist, speech pathologist, certified nurse midwife or other advanced practice registered nurse, licensed certified midwife, licensed midwife, marriage and family therapist, athletic trainer, or licensed acupuncturist, reimbursement under the policy shall not be denied because the service is rendered by the licensed practitioner, provided that, for services performed by an athletic trainer, such service is performed in an office setting.

B. If an accident and sickness insurance policy provides reimbursement for a service that may be legally performed by a licensed pharmacist, reimbursement under the policy shall not be denied because the service is rendered by the licensed pharmacist, provided that (i) the service is performed for an insured for a condition under the terms of a collaborative agreement, as defined in § 54.1-3300, (ii) the service is for the administration of vaccines for immunization, or (iii) the service is provided in accordance with § 54.1-3303.1.

C. The reimbursement for a service provided by a licensed certified midwife or licensed midwife shall be in the same amount as the reimbursement paid under the policy to a certified nurse midwife for performing such service in the area served, provided that the claim is submitted using (i) the diagnoses and procedure codes applicable to the service; (ii) such licensed certified midwife's or licensed midwife's name; (iii) the national provider identifier for the licensed certified midwife or licensed midwife providing the service; and (iv) if required by the insurer, the facility in which the service is provided.

D. No insurer shall reduce the reimbursement paid to a certified nurse midwife in order to comply with the provisions of this section.

E. This section shall not apply to Medicaid, or any state fund.

1968, c. 588, § 38.1-347.1; 1973, c. 428; 1979, c. 13; 1986, c. 562; 1987, cc. 549, 551, 557; 1989, cc. 7, 201; 1997, c. 203; 1998, c. 146; 2001, cc. 102, 475; 2019, cc. 332, 333; 2020, cc. 726, 731; 2022, cc. 440, 441; 2023, c. 183; 2025, c. 695.