Virginia
highProcedure Fee Files
Run Date and Time
Aug 15, 2026
1m 50s
Run Metrics
Fee Schedule Impacts
Run summary
This run for Virginia DMAS Procedure Fee Files / procedure-fee-files identified 8 changed documents and 0 newly discovered documents. 7 item(s) are high priority.
High Impact (7)
cptmedical4.txt
The document update includes a change in the reimbursement rate for CPT code 87494, effective January 1, 2026. The rate has been updated from 'ic' to '000061.76'.
Highlights
- •CPT code 87494 rate updated to 000061.76
- •Effective date for change: 01/01/2026
- •Previous rate was 'ic'
Reason
The update involves a specific numeric rate change for a CPT code effective soon, impacting reimbursement.
Watch items
hcpcmedical.txt
The document update involves a rate change for the service code H0038, 'community guide/peer mentoring,' effective from July 1, 2024, to June 30, 2026. The rate has been updated from $37.49 to $38.24.
Highlights
- •Service code H0038 updated.
- •Rate changed from $37.49 to $38.24.
- •Effective date: 07/01/2024 to 06/30/2026.
Reason
The update includes a specific rate change effective soon, impacting reimbursement.
Watch items
audtrail.csv
The document update includes new entries for procedure code T2033 with varying rates and effective dates starting from July 1, 2025, and July 1, 2026. These changes appear to replace previous entries, indicating a significant update to reimbursement rates.
Highlights
- •New entries for procedure code T2033.
- •Rates vary from $350.31 to $579.35.
- •Effective dates: 07/01/2025 and 07/01/2026.
- •Old entries for codes 97530, 97167, 97166, 97165 removed.
Reason
The update includes new reimbursement rates and effective dates for procedure code T2033, impacting billing and reimbursement.
Watch items
audtrail.txt
The document update includes new entries for procedure code T2033 with varying rates and effective dates starting from July 1, 2025, and July 1, 2026. These changes appear to replace previous entries, indicating a significant update to reimbursement rates.
Highlights
- •New entries for procedure code T2033 with different rates.
- •Effective dates include July 1, 2025, and July 1, 2026.
- •Rates range from $350.31 to $579.35.
- •Old entries for codes 97530, 97167, 97166, 97165, and 97163 removed.
Reason
The update includes new reimbursement rates and effective dates, impacting billing and reimbursement.
Watch items
cptmedical4.csv
The document update includes a change in the reimbursement rate for CPT code 87494, effective January 1, 2026. The rate has been updated from 'ic' to '000061.76'.
Highlights
- •CPT code 87494 rate updated to 000061.76
- •Effective date for change: 01/01/2026
- •Previous rate was 'ic'
Reason
The update involves a specific numeric rate change for a CPT code effective soon, impacting reimbursement.
Watch items
cptmedical3.csv
The document update includes a rate change for CPT code 77387, effective July 1, 2026, with a new rate of $31.54. This change is significant as it impacts reimbursement rates for medical services related to radiation therapy delivery guidance.
Highlights
- •CPT code 77387 rate updated to $31.54
- •Effective date for new rate: July 1, 2026
- •Previous rate was $47.00 until June 30, 2026
Reason
The update includes a specific rate change effective soon, impacting reimbursements.
Watch items
cptmedical3.txt
The document update includes a rate change for CPT code 77387, effective July 1, 2026, with a new rate of $31.54. This change is significant as it impacts reimbursement rates for medical services.
Highlights
- •CPT code 77387 rate updated to $31.54
- •Effective date for new rate: July 1, 2026
- •Previous rate was $47.00 until June 30, 2026
Reason
The update includes a specific rate change effective soon, impacting reimbursements.
Watch items
Medium Impact (1)
hcpcmedical.csv
The document update involves a change in the rate for the service code H0038, 'community guide/peer mentoring,' from $37.49 to $38.24, effective from July 1, 2026. This change impacts the reimbursement rate for this service.
Highlights
- •Service code H0038 rate changed from $37.49 to $38.24.
- •Effective date for new rate: July 1, 2026.
- •Service: community guide/peer mentoring.
Reason
The rate change is relevant but not immediately effective, requiring future attention.
Watch items
Low Impact (0)
No documents in this severity group.