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Update to Durable Medical Equipment and Supplies Rates

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Effective Date:

All Durable Medical Equipment and Supplies providers participating in the Virginia Medical Assistance Program, Managed Care Organizations, and holders of the Durable Medical Equipment and Supplies Provider Manual
Cheryl J. Roberts, Director Department of Medical Assistance Services (DMAS)


The purpose of this bulletin is to highlight changes to rates for Durable Medical Equipment and Supplies.  The rate document has been updated and is now available on the DMAS website here. Please refer to each section of the  rate document for changes to that section.  All changes are noted in BOLD with effective dates noted at the bottom of each document.  All competitive bid rates are highlighted in blue.  The  rates are effective 01/01/2023.  Claims submitted prior to the date of this memo for service dates back to 01/01/2023 will be reprocessed.

If providers are unsure of the appropriate code to use for a particular item, one resource is the DME classification site, which is designed to assist providers with DME coding.  Providers can search by different criteria and by brand name. The website can be accessed at



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


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.

For credentialing and behavioral health service information, visit:, 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+)

Virginia Premier

1-800-727-7536 (TTY: 711),