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Outpatient Rehabilitation Rates Effective July 1, 2023

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Effective Date:

All Providers of Outpatient Rehabilitation Services Participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)
Cheryl J. Roberts, Director Department of Medical Assistance Services (DMAS)

The purpose of this bulletin is to inform providers that, effective July 1, 2023, the rates for outpatient rehabilitation services will be updated in accordance with Chapter 12 of the Virginia Administrative Code, Section 30-80-200.

Outpatient rehabilitation rates effective July 1, 2023 may be found on the DMAS web site at under the Rehab Agencies heading.

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  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  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; 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.




Virginia Medicaid Web Portal Automated Response System (ARS)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

Medicall (Audio Response System)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

1-800-884-9730 or 1-800-772-9996

Acentra Health

Service authorization information for fee-for-service members.


Provider Appeals

DMAS launched an appeals portal in 2021. You can use this portal to file appeals and track the status of your appeals. Visit the website listed for appeal resources and to register for the portal.

Managed Care Programs

Medallion 4.0, Commonwealth Coordinated Care Plus (CCC Plus), and Program of All-Inclusive Care for the Elderly (PACE).  In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider.  The managed care plan may utilize different guidelines than those described for Medicaid fee-for-service individuals.

Medallion 4.0

CCC Plus


Magellan Behavioral Health

Behavioral Health Services Administrator, check eligibility, claim status, service limits, and service authorizations for fee-for-service members., email:,or

Call: 1-800-424-4046

Provider Enrollment

In-State: 804-270-5105

Out of State Toll Free: 888-829-5373



Monday–Friday 8:00 a.m.-5:00 p.m.  For provider use only, have Medicaid Provider ID Number available.



Aetna Better Health of Virginia


 1-866-386-7882 (CCC+)

Anthem HealthKeepers Plus


1-833-235-2027 (CCC+)

Molina Complete Care


1-800-424-4524 (CCC+)

1-800-424-4518 (M4)

Optima Family Care


1-844-374-9159 (CCC+)

United Healthcare


1-855-873-3493 (CCC+)

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