Virginia
highProcedure Fee Files
Run Date and Time
May 15, 2026
2m 30s
Run Metrics
Fee Schedule Impacts
Run summary
This run for Virginia DMAS Procedure Fee Files / procedure-fee-files identified 12 changed documents and 0 newly discovered documents. 2 item(s) are high priority.
High Impact (2)
audtrail.txt
The document shows significant updates to Medicaid rates, with new procedure codes and rates effective January 1, 2026. Previous rates and codes have been replaced, indicating a major update to the reimbursement schedule.
Highlights
- •New procedure codes: 55711, 55707, 37280, 37291, 37273, q5148, q5135
- •Effective date for new rates: 01/01/2026
- •Old codes like 97610 have been removed
- •Rates range from $0.99 to $11,629.11
- •End date for new rates: 12/31/9999
Reason
The changes include new procedure codes and rates effective soon, impacting reimbursement.
Watch items
audtrail.csv
The document shows significant updates to Medicaid rates, with new procedure codes and rates effective January 1, 2026. Previous rates and codes have been replaced, indicating a major update to the reimbursement schedule.
Highlights
- •New procedure codes: 55711, 55707, 37280, 37291, 37273, q5148, q5135
- •Effective date for new rates: 01/01/2026
- •Old codes and rates removed: 97610, 92229
- •New rates range from $0.99 to $11,629.11
Reason
The changes include new procedure codes and rates effective soon, impacting reimbursement.
Watch items
Medium Impact (10)
cptmedical2.txt
The document update includes a change in the billing setting for CPT code 33882 from 'op' (outpatient) to 'ip' (inpatient) with a rate of 001549.76, effective from 01/01/2026. This change could impact reimbursement for services billed under this code.
Highlights
- •CPT code 33882 billing setting changed from 'op' to 'ip'.
- •New rate for CPT code 33882 is 001549.76.
- •Effective date for changes is 01/01/2026.
Reason
The change affects future billing settings and rates, but the effective date is not imminent.
Watch items
cptmedical2.csv
The document update includes a change in the billing setting for CPT code 33882 from 'op' (outpatient) to 'ip' (inpatient) with a rate of 001549.76, effective from 01/01/2026. This change could impact reimbursement for services billed under this code.
Highlights
- •CPT code 33882 setting changed from 'op' to 'ip'.
- •New rate for 33882 is 001549.76.
- •Effective date for changes is 01/01/2026.
Reason
The change affects future billing settings and rates, but the effective date is not imminent.
Watch items
cptmedical1.csv
The document contains updates with effective dates starting January 1, 2026, and ending December 31, 9999. No specific rate changes or new codes are evident, but the effective date indicates future applicability.
Highlights
- •Effective date: 01/01/2026
- •End date: 12/31/9999
- •No specific rate changes noted
- •No new CPT/HCPCS codes identified
Reason
The changes are future-dated, indicating relevance but not immediate urgency.
Watch items
cptmedical4.txt
The document update includes new entries for CPT codes 81354 and 97008, effective from January 1, 2026, with no changes to reimbursement rates. These entries are marked as 'medical' and 'regular & csb'.
Highlights
- •New CPT code 81354 effective 01/01/2026
- •New CPT code 97008 effective 01/01/2026
- •No reimbursement rate changes noted
- •Entries marked as 'medical' and 'regular & csb'
Reason
The changes involve new CPT codes effective in the future, but no immediate reimbursement impact is indicated.
Watch items
hcpcmedical.csv
The document update includes changes to the reimbursement rates for the drug 'inj gadoterate meglumi 0.1ml' (CPT code A9575). The rate has been adjusted from 0.10 to 0.09, effective April 1, 2026. Additionally, a new rate of 0.11 is set to be effective from July 1, 2024, to December 31, 2025.
Highlights
- •CPT code A9575 rate change from 0.10 to 0.09 effective 04/01/2026.
- •New rate of 0.11 effective 07/01/2024 to 12/31/2025.
- •CPT code A9573 remains unchanged.
Reason
The changes are not immediate but involve future reimbursement rates, requiring attention for future planning.
Watch items
cptmedical4.csv
The document update includes new entries for CPT codes 81354 and 97008, both effective from 01/01/2026 to 12/31/9999. These changes are related to medical procedures and are set to take effect in the future.
Highlights
- •New CPT code 81354 added, effective 01/01/2026.
- •New CPT code 97008 added, effective 01/01/2026.
- •Both codes are valid until 12/31/9999.
Reason
The changes involve future effective dates, indicating no immediate impact but requiring awareness for future planning.
Watch items
cptmedical1.txt
The document contains updates with effective dates starting January 1, 2026, and ending December 31, 9999. It includes entries like '0600u' and '0601u' with descriptions related to medical conditions and procedures.
Highlights
- •Effective date: 01/01/2026
- •Entries: '0600u', '0601u'
- •Descriptions: 'nfct ds wnd infctj 65orgs&30', 'nfct ds pji alys 11 bmrks ia'
- •End date: 12/31/9999
Reason
The changes are not effective immediately but are upcoming, requiring review before the effective date.
Watch items
hcpcmedical.txt
The document update includes changes to the reimbursement rate for CPT code A9575, effective April 1, 2026. The rate has been adjusted from 0.10 to 0.09.
Highlights
- •CPT code A9575 rate change from 0.10 to 0.09
- •Effective date for new rate: 04/01/2026
- •Previous rate effective until 03/31/2026
Reason
The rate change is not immediate but scheduled for a future date, requiring attention for future planning.
Watch items
cptmedical3.csv
The document includes updates to CPT codes 52443 and 52450, with effective dates starting January 1, 2026, and July 1, 2025, respectively. These changes are set to last until December 31, 9999, indicating long-term applicability.
Highlights
- •CPT code 52443 effective from 01/01/2026 to 12/31/9999.
- •CPT code 52450 effective from 07/01/2025 to 12/31/9999.
- •No rate changes indicated.
- •Long-term applicability of codes.
Reason
The changes are not immediate but involve future effective dates for CPT codes, requiring attention for future planning.
Watch items
cptmedical3.txt
The document includes updates to CPT codes 52443 and 52450, with effective dates starting January 1, 2026, and July 1, 2025, respectively. These changes are set to last until December 31, 9999, indicating long-term applicability.
Highlights
- •CPT code 52443 effective from 01/01/2026 to 12/31/9999
- •CPT code 52450 effective from 07/01/2025 to 12/31/9999
Reason
The changes involve future effective dates, indicating no immediate urgency but relevance for upcoming policy adjustments.
Watch items
Low Impact (0)
No documents in this severity group.