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The purpose of this bulletin is to inform providers that select Early Intervention (EI) service rates will increase effective January 1, 2024. 

In accordance with Item 304.TTTT of the 2023 Virginia Acts of Assembly, the Department of Medical Assistance Services (DMAS) shall increase the reimbursement rates for Early Intervention (EI) services, excluding case management, by 12.5 percent for all children under age three enrolled in Early Intervention in Virginia Medicaid for dates of service on or after January 1, 2024. Please see a list of eligible EI codes below.

*Services and rates are subject to claims payment processing procedures which may result in different reimbursement according to billing practices and program participation. All claims are subject to post payment review.

Early Intervention Rates Effective January 1, 2024 

This memo serves as the official notification that Early Intervention rates effective January 1, 2024 are posted on the DMAS website at Procedure Fee Files & CPT Codes | DMAS - Department of Medical Assistance Services (virginia.gov). If you have any questions regarding Early Intervention rates please call the provider helpline at 800-552-8627.

Appeals Information

If you believe an error was made for payment rates or totals, you can file an appeal.  The appeal must be filed with the DMAS Appeals Division through one of the following methods: 

• Through the Appeals Information Management System at https://www.dmas.virginia.gov/appeals/. From there you can fill out an informal appeal request, submit documentation, and follow the process of your appeal. 

• Through mail, email, or fax.  You can download a Medicaid Provider Appeal Request form at https://www.dmas.virginia.gov/appeals/. You can use that form or a letter to file the informal appeal.  The appeal request must identify the issues being appealed. The request can be submitted by:  

  • Mail or delivery to: Appeals Division, Department of Medical Assistance Services, 600 E. Broad Street, Richmond, VA 23219; 

  • Email to appeals@dmas.virginia.gov; or 

  • Fax to (804) 452-5454. 

The appeal must be received by the DMAS Appeals Division within 30 days of the payment rate or total being published by DMAS. The notice of appeal is considered filed when it is date stamped by the DMAS Appeals Division.  The normal business hours of DMAS are from 8:00 a.m. through 5:00 p.m. on dates when DMAS is open for business. Documents received after 5:00 p.m. on the deadline date shall be untimely.