Chapter 80 - METHODS AND STANDARDS FOR ESTABLISHING PAYMENT RATE; OTHER TYPES OF CARE

Section 12VAC30-80-10 - General
Section 12VAC30-80-20 - Services that are reimbursed on a cost basis
Section 12VAC30-80-21 - Reimbursement for services furnished individuals residing in a freestanding psychiatric hospital or residential treatment center (Level C)
Section 12VAC30-80-25 - Reimbursement for federally qualified health centers (FQHCs) and rural health clinics (RHCs)
Section 12VAC30-80-26 - Reimbursement for Indian Health Service tribal 638 facilities
Section 12VAC30-80-30 - [Effective until 4/5/2025] Fee-for-service providers
Section 12VAC30-80-30 - [Effective 4/5/2025] Fee-for-service providers
Section 12VAC30-80-32 - Reimbursement for substance use disorder services
Section 12VAC30-80-35 - Fee for service: ambulatory surgery centers
Section 12VAC30-80-36 - Fee-for-service providers: outpatient hospitals
Section 12VAC30-80-40 - Fee-for-service providers: pharmacy
Section 12VAC30-80-50 - Third party liability
Section 12VAC30-80-60 - Reimbursement audit
Section 12VAC30-80-70 - Fee-for-service providers: Transportation
Section 12VAC30-80-75 - Local Education Agency (LEA) providers
Section 12VAC30-80-80 - Fee-for-service: Medicare coinsurance and deductibles
Section 12VAC30-80-90 - Fee-for-service: Eyeglasses
Section 12VAC30-80-95 - Fee-for-service: hearing aids (under EPSDT)
Section 12VAC30-80-96 - Fee-for-service: Early Intervention (under EPSDT)
Section 12VAC30-80-97 - Fee-for-service: behavioral therapy services under EPSDT
Section 12VAC30-80-100 - Fee-for-service: Expanded Prenatal Care
Section 12VAC30-80-110 - Fee-for-service: case management
Section 12VAC30-80-111 - Treatment foster care (TFC) case management
Section 12VAC30-80-115 - Fee-for-service: Early Discharge Follow-up Visit for Mothers and Newborns
Section 12VAC30-80-120 - Reimbursement for all other nonenrolled institutional and noninstitutional providers
Section 12VAC30-80-130 - Refund of overpayments
Section 12VAC30-80-140 - [Repealed]
Section 12VAC30-80-150 - Dispute resolution for state-operated providers
Section 12VAC30-80-160 - [Repealed]
Section 12VAC30-80-170 - Payment of Medicare Part A and Part B Deductible/Coinsurance
Section 12VAC30-80-180 - Establishment of rate per visit for home health services
Section 12VAC30-80-190 - State agency fee schedule for RBRVS
Section 12VAC30-80-200 - Prospective reimbursement for rehabilitation agencies or comprehensive outpatient rehabilitation facilities
Section 12VAC30-80-300 - Medicare equivalent of average commercial rate
Form - FORMS (12VAC30-80)
Section - DOCUMENTS INCORPORATED BY REFERENCE (12VAC30-80)