Virginia Medicaid reimbursement rates
68,591 current fee-for-service and managed-care rates from Virginia Medicaid, across 141 services and 10 programs, normalized by code, provider level and unit. Each links to one of 67 official source documents.
Last retrieved 2026-10-02. History back to 1972-07-01.
- Current rates
- 68,591
- Services
- 141
- Programs
- 10
- Lines with a plan rule
- 20of 22 service lines
By industry
Applied behavior analysis (ABA)Virginia rates, labor costs and changesBehavioral healthVirginia rates, labor costs and changesHome healthVirginia rates, labor costs and changesHome care & personal careVirginia rates, labor costs and changesPrivate duty nursingVirginia rates, labor costs and changesSkilled nursing facilitiesVirginia rates, labor costs and changesHospiceVirginia rates, labor costs and changesIntellectual & developmental disabilitiesVirginia rates, labor costs and changesOutpatient therapy (PT, OT, speech)Virginia rates, labor costs and changes
Virginia rates by service
The median current rate for each service, like-for-like by unit. Follow a service to compare it with every other state.
Most-compared billing codes in Virginia
Where Virginia ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | Virginia | All-state median | Rank |
|---|---|---|---|---|
| 10004 | Physician and practitioner services (fee schedule) | $31.83 | $36.98 | 18 of 25 |
| 10005 | Physician and practitioner services (fee schedule) | $54.11 | $65.15 | 18 of 25 |
| 10006 | Physician and practitioner services (fee schedule) | $37.33 | $41.54 | 17 of 25 |
| 10007 | Physician and practitioner services (fee schedule) | $69.44 | $82.81 | 18 of 25 |
| 10008 | Physician and practitioner services (fee schedule) | $40.80 | $52.43 | 18 of 25 |
| 10009 | Physician and practitioner services (fee schedule) | $80.73 | $100.27 | 18 of 25 |
| 10010 | Physician and practitioner services (fee schedule) | $57.00 | $71.32 | 18 of 25 |
| 10021 | Physician and practitioner services (fee schedule) | $49.38 | $53.00 | 18 of 25 |
| 10030 | Physician and practitioner services (fee schedule) | $102.43 | $122.87 | 18 of 25 |
| 10035 | Physician and practitioner services (fee schedule) | $61.63 | $75.57 | 20 of 25 |
| 10036 | Physician and practitioner services (fee schedule) | $31.83 | $38.24 | 19 of 25 |
| 10060 | Physician and practitioner services (fee schedule) | $87.09 | $75.17 | 9 of 25 |
| 10061 | Physician and practitioner services (fee schedule) | $150.17 | $128.72 | 9 of 25 |
| 10080 | Physician and practitioner services (fee schedule) | $91.15 | $78.73 | 11 of 25 |
| 10081 | Physician and practitioner services (fee schedule) | $146.12 | $146.12 | 13 of 25 |
| 10120 | Physician and practitioner services (fee schedule) | $88.54 | $79.49 | 10 of 25 |
| 10121 | Physician and practitioner services (fee schedule) | $148.73 | $137.63 | 11 of 25 |
| 10140 | Physician and practitioner services (fee schedule) | $100.12 | $89.02 | 10 of 25 |
| 10160 | Physician and practitioner services (fee schedule) | $79.28 | $69.52 | 9 of 25 |
| 10180 | Physician and practitioner services (fee schedule) | $152.20 | $151.28 | 12 of 25 |
| 11000 | Physician and practitioner services (fee schedule) | $21.12 | $26.25 | 18 of 25 |
| 11001 | Physician and practitioner services (fee schedule) | $11.00 | $13.80 | 17 of 25 |
| 11004 | Physician and practitioner services (fee schedule) | $437.21 | $437.21 | 13 of 25 |
| 11005 | Physician and practitioner services (fee schedule) | $600.12 | $574.70 | 9 of 25 |
| 11006 | Physician and practitioner services (fee schedule) | $540.51 | $542.16 | 14 of 25 |
| 11008 | Physician and practitioner services (fee schedule) | $211.81 | $208.64 | 12 of 25 |
| 11010 | Physician and practitioner services (fee schedule) | $216.15 | $243.78 | 17 of 25 |
| 11011 | Physician and practitioner services (fee schedule) | $229.46 | $268.00 | 16 of 25 |
| 11012 | Physician and practitioner services (fee schedule) | $313.95 | $374.27 | 17 of 25 |
| 11042 | Physician and practitioner services (fee schedule) | $48.32 | $56.10 | 17 of 25 |
| 11043 | Physician and practitioner services (fee schedule) | $119.79 | $143.40 | 18 of 25 |
| 11044 | Physician and practitioner services (fee schedule) | $174.19 | $202.01 | 17 of 25 |
| 11055 | Physician and practitioner services (fee schedule) | $11.86 | $16.75 | 20 of 25 |
| 11056 | Physician and practitioner services (fee schedule) | $17.07 | $24.83 | 19 of 25 |
| 11057 | Physician and practitioner services (fee schedule) | $21.99 | $31.27 | 19 of 25 |
| 11102 | Physician and practitioner services (fee schedule) | $26.04 | $34.98 | 19 of 25 |
| 11103 | Physician and practitioner services (fee schedule) | $15.34 | $20.25 | 19 of 25 |
| 11104 | Physician and practitioner services (fee schedule) | $32.99 | $43.87 | 19 of 25 |
| 11105 | Physician and practitioner services (fee schedule) | $18.52 | $23.93 | 19 of 25 |
| 11106 | Physician and practitioner services (fee schedule) | $40.22 | $53.40 | 19 of 25 |
Managed care in Virginia
123 plans on record, 56 state-directed payment records, 10,369 published capitation cells.
Who sets the rate, line by line →Recent rate changes and notices
Frequently asked questions
Where does Virginia publish its Medicaid fee schedules?
Virginia publishes rates across 67 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does Virginia publish?
68,591 rates are current across 141 services and 10 programs, with 313,025 versions on record since 1972-07-01.
Do Virginia Medicaid managed-care plans pay the fee schedule?
For 20 of 22 service lines, plan contracts or state law set a rule plans must follow (a floor, a state-set rate or a required pass-through). For the rest, plans negotiate. See the managed-care page for each line's rule and citation.
Other states
Your Virginia rate cardYour codes, what Virginia pays, what plans must pay, and every change in 2026.