Virginia Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Virginia, based on 2024 claims data.
2024 Overview
Procedures
2.8K
Total Claims
61.6M
Total Paid
$5.3B
Popular Services
Procedures
Showing 1–50 of 2,778 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| T1019 | Personal care ser per 15 min | 6,144,293 | $144.25 | $5.13 | $460.50 |
| S0109 | Methadone oral 5mg | 2,563,614 | $5.44 | $0.35 | $62.11 |
| H0020 | Alcohol and/or drug services | 2,518,996 | $8.89 | $0.00 | $61.50 |
| T2003 | N-et; encounter/trip | 2,327,531 | $38.73 | $1.37 | $385.52 |
| 99214 | Office o/p est mod 30 min | 2,223,100 | $80.08 | $0.00 | $719.00 |
| 99213 | Office o/p est low 20 min | 1,948,169 | $64.98 | $0.00 | $719.00 |
| T1005 | Respite care service 15 min | 1,290,396 | $79.04 | $3.72 | $1,248.08 |
| 99284 | Emergency dept visit mod mdm | 825,417 | $151.43 | $0.00 | $486.12 |
| 90837 | Psytx w pt 60 minutes | 814,803 | $98.77 | $0.00 | $753.24 |
| 85025 | Complete cbc w/auto diff wbc | 809,959 | $1.77 | $0.00 | $719.00 |
| H0046 | Mental health service, nos | 762,852 | $201.95 | $50.32 | $1,326.41 |
| 80053 | Comprehen metabolic panel | 706,090 | $2.83 | $-0.04 | $719.00 |
| 36415 | Coll venous bld venipuncture | 637,105 | $3.04 | $0.00 | $719.00 |
| 99283 | Emergency dept visit low mdm | 542,228 | $212.77 | $0.00 | $453.00 |
| 99285 | Emergency dept visit hi mdm | 497,761 | $167.30 | $0.00 | $624.71 |
| 97530 | Therapeutic activities | 484,790 | $53.55 | $0.00 | $2,747.64 |
| 97110 | Therapeutic exercises | 475,086 | $40.40 | $0.00 | $2,022.19 |
| J3490 | Drugs unclassified injection | 452,762 | $0.25 | $0.00 | $94.40 |
| 92507 | Tx sp lang voice comm indiv | 400,451 | $106.55 | $0.00 | $502.57 |
| 71045 | X-ray exam chest 1 view | 390,768 | $3.94 | $0.00 | $136.25 |
| H2012 | Behav hlth day treat, per hr | 340,651 | $196.13 | $9.90 | $2,300.00 |
| 87880 | Strep a assay w/optic | 339,756 | $10.53 | $0.00 | $259.36 |
| D0120 | Periodic oral evaluation | 334,026 | $1.00 | $0.00 | $34.66 |
| H2017 | Psysoc rehab svc, per 15 min | 333,442 | $76.14 | $14.30 | $558.69 |
| 81001 | Urinalysis auto w/scope | 316,208 | $0.98 | $0.00 | $719.00 |
| G0463 | Hospital outpt clinic visit | 309,604 | $171.83 | $4.76 | $281.65 |
| 80048 | Basic metabolic pnl total ca | 301,240 | $1.60 | $0.00 | $719.00 |
| 87804 | Influenza assay w/optic | 298,500 | $10.35 | $0.00 | $34.69 |
| 85027 | Complete cbc automated | 289,501 | $1.49 | $0.00 | $719.00 |
| 93005 | Electrocardiogram tracing | 289,426 | $2.49 | $0.00 | $48.76 |
| 93010 | Electrocardiogram report | 285,598 | $5.18 | $0.00 | $16.37 |
| 3008F | Body mass index docd | 285,005 | $0.08 | $0.00 | $23.41 |
| H0023 | Alcohol and/or drug outreach | 281,838 | $347.39 | $0.00 | $367.31 |
| A0130 | Noner transport wheelch van | 278,535 | $56.40 | $9.59 | $302.94 |
| 71046 | X-ray exam chest 2 views | 270,223 | $11.17 | $0.00 | $133.04 |
| 99309 | Sbsq nf care moderate mdm 30 | 265,094 | $26.88 | $0.00 | $129.68 |
| H2016 | Comp comm supp svc, per diem | 262,001 | $109.31 | $26.03 | $904.20 |
| 80305 | Drug test prsmv dir opt obs | 257,425 | $11.01 | $0.00 | $16.12 |
| 92508 | Tx sp lang voice comm group | 256,944 | $13.37 | $7.99 | $67.05 |
| D1206 | Topical fluoride varnish | 252,865 | $0.75 | $0.00 | $31.25 |
| 3074F | Syst bp lt 130 mm hg | 252,019 | $3.47 | $0.00 | $25.00 |
| H2022 | Com wrap-around sv, per diem | 251,629 | $1,447.47 | $293.70 | $15,397.06 |
| 80307 | Drug test prsmv chem anlyzr | 251,502 | $57.78 | $0.00 | $719.00 |
| 96374 | Ther/proph/diag inj iv push | 248,193 | $8.33 | $0.00 | $1,025.74 |
| D1120 | Dental prophylaxis child | 247,192 | $1.38 | $0.00 | $46.56 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 241,627 | $40.25 | $0.00 | $71.41 |
| 83735 | Assay of magnesium | 226,427 | $0.61 | $0.00 | $18.45 |
| 1159F | Med list docd in rcrd | 224,601 | $0.01 | $0.00 | $10.49 |
| 97112 | Neuromuscular reeducation | 222,637 | $29.01 | $0.00 | $252.84 |
| 97153 | Adaptive behavior tx by tech | 221,829 | $229.34 | $30.50 | $2,392.11 |