Virginia

high

Procedure Fee Files

SUCCESS

Run Date and Time

Jul 01, 2026

12m 15s

Run Metrics

New0
Changed6
Unchanged8
Checked14

Fee Schedule Impacts

High3
Medium3
Low0

Run summary

This run for Virginia DMAS Procedure Fee Files / procedure-fee-files identified 6 changed documents and 0 newly discovered documents. 3 item(s) are high priority.

High Impact (3)

cptmedical3.txt

high

The document update includes a change in the reimbursement rate for CPT code 77387, effective July 1, 2026. The rate changes from $47.00 to $31.54.

Highlights

  • CPT code 77387 rate change from $47.00 to $31.54
  • Effective date for new rate: July 1, 2026
  • Old rate effective until June 30, 2026

Reason

The change involves a specific reimbursement rate update effective soon, impacting billing and reimbursement.

Watch items

CPT code 77387Effective date: July 1, 2026Old rate: $47.00New rate: $31.54

audtrail.txt

high

The document shows updates to Medicaid rates effective July 1, 2026, with new procedure codes and rates replacing older entries. These changes include specific rates for both inpatient and outpatient services.

Highlights

  • New procedure code 99449 added.
  • Rates for code 99449: $54.93 (outpatient), $45.77 (inpatient).
  • Effective date for changes: July 1, 2026.
  • Old codes and rates removed.

Reason

The changes involve specific rate updates and new procedure codes effective soon, impacting reimbursement.

Watch items

9944907/01/2026$54.93$45.77

audtrail.csv

high

The document update includes new procedure codes and rates effective July 1, 2026, with significant changes in the rate schedule.

Highlights

  • New procedure code 99449 added.
  • Rates for code 99449: $54.93 (OP), $45.77 (IP) for region 0002.
  • Effective date for changes: July 1, 2026.
  • Old codes and rates removed.

Reason

The update includes new rates and codes effective soon, impacting reimbursement.

Watch items

9944907/01/2026$54.93$45.77
Medium Impact (3)

cptmedical3.csv

medium

The document update involves a change in the reimbursement rate for CPT code 77387, effective July 1, 2026. The rate changes from $47.00 to $31.54, impacting future billing for this service.

Highlights

  • CPT code 77387 rate change from $47.00 to $31.54
  • Effective date for new rate: July 1, 2026
  • Old rate effective until June 30, 2026

Reason

The rate change is significant but not immediately effective, allowing time for review.

Watch items

CPT code 77387Effective date: July 1, 2026Old rate: $47.00New rate: $31.54

cptmedical4.csv

medium

The document update includes changes to CPT code 99448, with new rates effective from July 1, 2026. The rate for inpatient services for those under 21 is set at 34.41, and for outpatient services, it is 40.91.

Highlights

  • CPT code 99448 updated.
  • New inpatient rate: 34.41 effective 07/01/2026.
  • New outpatient rate: 40.91 effective 07/01/2026.
  • Applies to age <21.

Reason

The changes are relevant but not urgent as they are effective in 2026.

Watch items

CPT 99448Effective date 07/01/2026Rate 34.41Rate 40.91

cptmedical4.txt

medium

The document update includes changes to CPT code 99448, with new rates effective from July 1, 2026, for services involving patients under 21 years old.

Highlights

  • CPT code 99448 updated.
  • New rate of 000034.41 for inpatient services effective 07/01/2026.
  • New rate of 000040.91 for outpatient services effective 07/01/2026.
  • Applies to patients under 21 years old.

Reason

The changes are relevant but not urgent as they are effective in 2026.

Watch items

CPT 9944807/01/2026000034.41000040.91
Low Impact (0)

No documents in this severity group.