Every state, kept current
The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Virginia state-specific services schedule has 327 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Published codes
327
state-specific and temporary HCPCS codes on the 2026 schedule
Median % of Medicare
59.8%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Common state-specific and temporary HCPCS codes and what Virginia Medicaid pays
A curated sample of recognizable procedures from the 327-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.
| Code | Procedure | Virginia rate | % of Medicare |
|---|---|---|---|
| S5125 | Attendant care services; per 15 minutes | $1.18 | -- |
| T1015 | Clinic visit/encounter, all-inclusive | $6.12 | -- |
| T1019 | Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) | $23.81 | -- |
| T2021 | Day habilitation, waiver; per 15 minutes | $52.12 | -- |
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
- Virginia Medicaid fee schedule 2026, all categories
- Virginia physician fee schedule · 6,706 codes
- Virginia lab & imaging fee schedule · 2,192 codes
- Virginia dme & supplies fee schedule · 1,933 codes
- Virginia drugs fee schedule · 882 codes
- Virginia vision fee schedule · 121 codes
- Virginia behavioral health fee schedule · 62 codes
State-Specific Services rates in neighboring states
Frequently asked questions
What does Virginia Medicaid pay for state-specific and temporary HCPCS services?
Virginia Medicaid publishes 327 state-specific and temporary HCPCS code rates effective 2026, paying a median 59.8% of the national Medicare amount for the same services. The schedule covers clinic and screening encounters, telehealth facility fees, personal care, and other C, Q, S and T 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 state-specific services rates compare with Medicare?
Across state-specific services codes with a national Medicare comparator, Virginia Medicaid pays a median 59.8% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.
Do state-specific and temporary HCPCS 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.