Virginia Medicaid Drugs Fee Schedule 2026

Virginia Medicaid publishes 882 drugs procedure rates effective 2026 on its fee-for-service schedule. This page shows published rates for common drugs procedures with plain-language descriptions and, where a comparator exists, each rate as a percentage of national Medicare.

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The table on this page is a common-procedure sample. The full Virginia drugs schedule has 882 codes.

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Published codes

882

Drugs procedures on the 2026 schedule

Median % of Medicare

--

no national Medicare comparator for this category

Effective vintage

2026

latest effective year on the schedule

Common drugs procedures and what Virginia Medicaid pays

A curated sample of recognizable procedures from the 882-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.

CodeProcedureVirginia rate% of Medicare
J0696Injection, ceftriaxone sodium, per 250 mg$0.40--
J1100Injection, dexamethasone sodium phosphate, 1 mg$0.08--
J1885Injection, ketorolac tromethamine, per 15 mg$0.28--
J2550Injection, promethazine hcl, up to 50 mg$3.63--
J3420Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg$0.68--
J7030Infusion, normal saline solution , 1000 cc$2.18--
J7613Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg$0.06--

Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * show the schedule's representative published variant.

More Virginia Medicaid fee schedules

Drugs rates in neighboring states

Frequently asked questions

What does Virginia Medicaid pay for physician-administered drugs?

Virginia Medicaid publishes 882 drugs procedure rates effective 2026 on its fee-for-service schedule. The schedule covers injectable and infused medications billed under HCPCS J-codes. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.

How do Virginia's drugs rates compare with Medicare?

Most drugs codes in this category have no direct national Medicare comparator (Medicare prices these services through different mechanisms), so a median comparison is not published here.

Do drugs services need prior authorization in Virginia?

Virginia does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".

Where do these rates come from?

Directly from Virginia's published Medicaid fee-for-service schedule (effective 2026), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.

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