Virginia
highProcedure Fee Files
Run Date and Time
Apr 15, 2026
7m 1s
Run Metrics
Fee Schedule Impacts
Run summary
This run for Virginia DMAS Procedure Fee Files / procedure-fee-files identified 6 changed documents and 0 newly discovered documents. 6 item(s) are high priority.
High Impact (6)
audtrail.txt
The document shows significant changes in procedure codes and rates, with new entries for code 97610 replacing previous entries for code q5130. The effective dates for these changes are upcoming, starting from July 1, 2025.
Highlights
- •Procedure code q5130 replaced by 97610.
- •New rates for 97610: $349.19 (outpatient), $15.07 (inpatient).
- •Effective date for new rates: July 1, 2025.
- •Old rates for q5130 ranged from $127.22 to $183.51.
Reason
The changes involve new procedure codes and rates effective soon, impacting reimbursement.
Watch items
cptmedical4.csv
The document update includes a change in the reimbursement rate for CPT code 92229, effective July 1, 2025. The rate for inpatient services is set at $38.39, replacing the previous rate of $0.00.
Highlights
- •CPT code 92229 updated
- •New rate: $38.39 for inpatient services
- •Effective date: 07/01/2025
- •Previous rate was $0.00
Reason
The update involves a specific rate change for a CPT code effective soon, impacting reimbursement.
Watch items
hcpcmedical.txt
The document update includes changes to the effective dates for the drug 'inj. denosumab-bbdz, 1 mg' with code Q5136. The new effective date is April 1, 2026, with a rate of $27.70. This change is set to last until December 31, 9999.
Highlights
- •Code Q5136: 'inj. denosumab-bbdz, 1 mg'
- •New effective date: 04/01/2026
- •Rate: $27.70
- •End date: 12/31/9999
Reason
The update includes a new effective date and rate for a specific drug, impacting reimbursement.
Watch items
cptmedical4.txt
The document update includes a change in the reimbursement rate for CPT code 92229, effective July 1, 2025. The rate for inpatient services is set at $38.39.
Highlights
- •CPT code 92229 updated
- •New rate: $38.39 for inpatient
- •Effective date: 07/01/2025
Reason
The update includes a specific rate change effective soon, impacting reimbursement.
Watch items
audtrail.csv
The document shows significant changes in procedure codes and rates, with new entries for code 97610 replacing previous entries for code q5130. The new rates are effective from July 1, 2025, with some rates applicable from July 1, 2024, indicating a substantial update to the reimbursement schedule.
Highlights
- •New procedure code 97610 replaces q5130.
- •New rates for 97610 effective from 07/01/2025.
- •Rates for 97610 range from $15.06 to $364.60.
- •Old rates for q5130 ranged from $127.22 to $183.51.
- •Effective dates for new rates extend to 12/31/9999.
Reason
The changes involve new procedure codes and rates effective soon, impacting reimbursement.
Watch items
hcpcmedical.csv
The document update includes changes to the effective dates for the drug 'inj. denosumab-bbdz, 1 mg' with code Q5136. The new effective date is April 1, 2026, with a rate of $27.70.
Highlights
- •Code Q5136: 'inj. denosumab-bbdz, 1 mg'
- •New effective date: 04/01/2026
- •Rate: $27.70
Reason
The update includes a new effective date and rate for a specific drug, impacting reimbursement.
Watch items
Medium Impact (0)
No documents in this severity group.
Low Impact (0)
No documents in this severity group.