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Methods and Standards for Establishing Payment Rate; Other Types of Care | Midpage
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Virginia Administrative Code
Title 12
30
Chapter 80
Methods and Standards for Establishing Payment Rate; Other Types of Care
10
General.
20
Services that are reimbursed on a cost basis.
21
Reimbursement for services furnished individuals residing in a freestanding psychiatric hospital or residential treatment center (Level C).
25
Reimbursement for federally qualified health centers (FQHCs) and rural health clinics (RHCs).
26
Reimbursement for Indian Health Service tribal 638 facilities.
30
Fee-for-service providers.
32
Reimbursement for substance use disorder services.
35
Fee for service: ambulatory surgery centers.
36
Fee-for-service providers: outpatient hospitals.
40
Fee-for-service providers: pharmacy.
50
Third party liability.
60
Reimbursement audit.
70
Fee-for-service providers: Transportation.
75
Local Education Agency (LEA) providers.
80
Fee-for-service: Medicare coinsurance and deductibles.
90
Fee-for-service: Eyeglasses.
95
Fee-for-service: hearing aids (under EPSDT).
96
Fee-for-service: Early Intervention (under EPSDT).
97
Fee-for-service: behavioral therapy services under EPSDT.
100
Fee-for-service: Expanded Prenatal Care.
110
Fee-for-service: case management.
111
Treatment foster care (TFC) case management.
115
Fee-for-service: Early Discharge Follow-up Visit for Mothers and Newborns.
120
Reimbursement for all other nonenrolled institutional and noninstitutional providers.
130
Refund of overpayments.
150
Dispute resolution for state-operated providers.
170
Payment of Medicare Part A and Part B Deductible/Coinsurance.
180
Establishment of rate per visit for home health services.
190
State agency fee schedule for RBRVS.
200
Prospective reimbursement for rehabilitation agencies or comprehensive outpatient rehabilitation facilities.
300
Medicare equivalent of average commercial rate.
9998
Forms (12Vac30-80).
9999
Documents Incorporated by Reference (12Vac30-80).