Virginia
highProcedure Fee Files
Run Date and Time
Jul 15, 2026
1m 43s
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. 2 item(s) are high priority.
High Impact (2)
cptmedical4.csv
The document shows changes to the reimbursement rate for CPT code 96127, effective from July 1, 2025. The rate is set at $4.96, replacing the previous rate of $5.13, which was effective until June 30, 2025.
Highlights
- •CPT code 96127 rate change to $4.96
- •Effective date: July 1, 2025
- •Previous rate: $5.13 until June 30, 2025
Reason
The change impacts reimbursement rates effective soon, requiring immediate review.
Watch items
cptmedical4.txt
The document shows changes to the reimbursement rate for CPT code 96127, effective from July 1, 2025. The rate is set at $4.96, replacing previous rates that were effective until June 30, 2025.
Highlights
- •CPT code 96127 rate change to $4.96
- •Effective date: 07/01/2025
- •Previous rate effective until 06/30/2025
Reason
The change impacts reimbursement rates effective soon, requiring immediate review.
Watch items
Medium Impact (4)
hcpcmedical.txt
The document update involves a change to the wellness assessment code S5190, with a new effective date of 07/01/2026. The rate remains at 000153.12, and the coverage period extends to 12/31/9999.
Highlights
- •Code S5190: Wellness assessment
- •New effective date: 07/01/2026
- •Rate: 000153.12
- •Coverage period: 07/01/2026 to 12/31/9999
Reason
The change involves a future effective date, indicating a planned update rather than an immediate impact.
Watch items
hcpcmedical.csv
The document update includes a change related to the wellness assessment service (CPT code S5190) with an effective date of July 1, 2026. The rate for this service is set at $153.12.
Highlights
- •CPT code S5190: wellness assessment
- •Effective date: 07/01/2026
- •Rate: $153.12
Reason
The change is relevant but not urgent as the effective date is in the future (2026).
Watch items
audtrail.txt
The document indicates the removal of several rate entries, including those effective from 2025 to 2026, with no new rates provided. This suggests a potential update or deletion of existing rates.
Highlights
- •Removed rates effective from 2025 to 2026.
- •No new rates or entries added.
- •Entries include codes like q5147 and q5130.
Reason
The removal of rate entries without replacements suggests a change, but lack of new rates limits immediate impact assessment.
Watch items
audtrail.csv
The document indicates the removal of several rate entries, including those effective from 2025 to 2026, with no new rates added. This suggests a potential update or removal of certain reimbursement rates.
Highlights
- •Removed rates effective 2025-2026.
- •No new rates added.
- •Entries include codes like q5147 and q5130.
Reason
The removal of rates could impact reimbursements, but no new rates are provided, limiting immediate urgency.
Low Impact (0)
No documents in this severity group.