Virginia
highProcedure Fee Files
Run Date and Time
Sep 01, 2026
13m 57s
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. 1 item(s) are high priority.
High Impact (1)
audtrail.csv
The document update includes new rate entries for procedure codes J9381 and Q5124, with effective dates starting in 2025 and 2026. These changes involve specific rate adjustments and new effective periods.
Highlights
- •New rates for J9381 effective from 04/01/2026.
- •New rates for Q5124 effective from 04/01/2026.
- •Rates for J9381 range from $37.30 to $38.39.
- •Rates for Q5124 range from $59.09 to $70.90.
Reason
The changes include specific rate updates and new effective dates starting soon, impacting reimbursement.
Watch items
Medium Impact (5)
hcpcmedical.txt
The document includes updates with new entries effective from July 1, 2026, such as 'c1609' and 'q5170'. These entries are set to remain effective until December 31, 9999, indicating long-term applicability.
Highlights
- •New entries 'c1609' and 'q5170' effective from 07/01/2026.
- •Entries valid until 12/31/9999.
- •No specific rate changes provided.
Reason
The changes are relevant but not immediately effective, with no specific rate changes detailed.
Watch items
cptmedical4.csv
The document includes updates to the effective dates for certain vaccines, specifically the 'tirv vacc mrna 37.5/0.38 im' with CPT code 90616, now effective from 07/01/2026. No rate changes are evident.
Highlights
- •CPT code 90616 effective date updated to 07/01/2026.
- •No rate changes detected for CPT code 90616.
- •CPT code 90619 remains unchanged with historical effective date.
Reason
The update involves future effective dates for a vaccine, but no immediate rate or policy changes are evident.
Watch items
cptmedical4.txt
The document includes updates to vaccine codes, specifically CPT code 90616 for a vaccine effective from 07/01/2026. No immediate changes to reimbursement rates or policies are evident.
Highlights
- •CPT code 90616 effective 07/01/2026
- •No rate changes identified
- •No immediate policy changes noted
Reason
The document contains future effective dates but lacks immediate reimbursement-impacting changes.
Watch items
audtrail.txt
The document update includes changes to Medicaid rates for specific procedure codes, with new rates effective from 2025 to 2026. Notably, the rates for procedure code J9381 have been updated with specific effective dates.
Highlights
- •Procedure code J9381 has new rates effective from 07/01/2025 to 12/31/2025.
- •Rates for J9381 are also set for 01/01/2026 to 03/31/2026 and 04/01/2026 onward.
- •Procedure code Q5124 has updated rates effective from 10/01/2025 to 12/31/2025 and 04/01/2026 onward.
Reason
The changes involve future rate updates, but the effective dates are not imminent.
Watch items
hcpcmedical.csv
The document includes updates with new entries effective from July 1, 2026, such as 'c1609' and 'q5170'. These entries are set to be active until December 31, 9999, indicating long-term applicability.
Highlights
- •New entries 'c1609' and 'q5170' added.
- •Effective date for new entries: July 1, 2026.
- •Entries valid until December 31, 9999.
Reason
Changes are relevant but effective date is not imminent.
Watch items
Low Impact (2)
cptmedical1.csv
The document contains updates to Medicaid rate information, including CPT codes 0631u and 0632t, with effective dates starting 07/01/2026. No immediate changes are noted for current rates or policies.
Highlights
- •CPT code 0631u effective 07/01/2026.
- •CPT code 0632t effective 01/01/2021.
- •No rate changes noted.
- •Future effective dates for new codes.
Reason
The changes are not effective immediately and do not impact current reimbursement rates.
Watch items
cptmedical1.txt
The document contains updates to Medicaid rate entries, including CPT codes 0631u and 0632t, with effective dates starting from 07/01/2026. No immediate changes are effective now.
Highlights
- •CPT code 0631u effective 07/01/2026
- •CPT code 0632t effective 01/01/2021
- •No rate changes observed
- •Entries valid until 12/31/9999
Reason
The changes are not effective immediately and do not impact current reimbursement rates.
Watch items