2012 Memos and Bulletins
Important Notice: Provider Memos and Bulletins issued prior to 2020 will no longer be available for download from this website. These Memos and Bulletins are still available by request directly from DMAS. To request a memo or bulletin from 2020 or earlier, please email the MES document team here: dezari.alexander@dmas.virginia.gov
Listings of memos and bulletins for years prior to 2020 are still available. Please include the Title and Issue Date when making your email request.
| Issue Date | Title | To: |
| 28-Dec-12 | Higher Payments for Medicaid Primary Care Services - Effective January 1, 2013 thru Higher Payments for Medicaid Primary Care Services - Effective January 1, 2013 thru Higher Payments for Medicaid Primary Care Services - Effective January 1, 2013 thru Higher Payments for Medicaid Primary Care Services - Effective January 1, 2013 thru December 31, 2014 | All Physicians, Nurse Practitioners and Health Department Clinics furnishing Primary Care Services and participating in the Virginia Medical Assistance Program, Managed Care Organizations providing services to Virginia Medicaid members |
| 21-Dec-12 | Changes to the 2013 American Medical Association’s (AMA) Current Procedural Terminology (CPT) for Psychiatry Services - Effective January 1, 2013 | Physicians with Specialty Psychiatry (071) or Psychologists (077), Licensed Professional Counselors, Licensed Psychologists, Clinical Psychologists, Clinical Nurse Specialists – Psychiatric only, State Health Department, Federally Qualified Health Center, Rural Health Clinic, Mental Health, Mental Retardation, Substance Abuse Clinics (FAMIS), Education Services, Licensed Clinical Social Workers, Psych Residential Inpatient Facilities, Licensed Social Workers, Out-of-State Physicians, Non-Medicaid TDO, School Psychologists, Licensed Marriage and Family Therapists, Substance Abuse Practitioners, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 21-Dec-12 | Notification of Enhancements to the Reimbursement Process of Transition Services — Notification of Enhancements to the Reimbursement Process of Transition Services - Effective January 1, 2013 | All Transition Services Providers Participating in the Virginia Medical Assistance Programs |
| 30-Nov-12 | Change to Reimbursement Methodology for Labor Epidurals (CPT 01967) – Effective January 1, 2013 | All Physicians and Other Providers Billing CPT Code 01967 (Labor Epidurals) Participating in the Virginia Medical Assistance Program, FAMIS, Managed Care Organizations Providing Services to Virginia Medicaid and FAMIS Recipients |
| 26-Nov-12 | Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program, New Drug Utilization Review (DUR) Board approved Service Authorization (SA) Requirements, and Changes to the Coverage of Benzodiazepines and Barbiturates for Medicare/Medicaid Dual Eligibles – Effective January 1, 2013 | All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs |
| 26-Nov-12 | Notification of Procedural Changes to Waiver Service Authorization End Dates and Changes to Duration of Service Authorizations - Effective January 1, 2013 | All Providers and Case Managers for Elderly or Disabled with Consumer Direction Waiver, Technology Assisted Waiver, Intellectual Disability (ID) Waiver, Day Support (DS) Waiver, Individual and Family Developmental Disabilities (IFDDS) Waiver, Case Managers for IFDDS Waiver, and Community Services Boards Providing Case Management for Intellectual Disability and Day Support Waiver Participating in the Virginia Medical Assistance Programs |
| 4-Oct-12 | Updated Training for Direct Support Professionals and their Supervisors/Trainers - REVISED | All Medicaid Enrolled Providers of Residential Support, Agency Directed Personal Assistance, Day Support, and Prevocational Services through the Intellectual Disability (ID) and Day Support (DS) Waivers Participating in the Virginia Medical Assistance Programs |
| 3-Oct-12 | Development of Special Criteria for the Purposes of Pre-Admission Screening | All Providers of Pre-Admission Screening Services Participating in the Virginia Medical Assistance Program and Managed Care Organizations |
| 3-Oct-12 | Notification of EPSDT Service Authorization Processing Moving to Keystone Peer Review Organization (KePRO) - Effective November 1, 2012 | All EPSDT Personal Care and Attendant Care Provider, Hearing Aid Providers, Audiologists, Assistive Technology Providers, and Private Duty Nursing Providers Participating in the Virginia Medical Assistance Programs |
| 3-Oct-12 | Notification of Long Term Care (LTC) Service Authorization Processing Moving to Keystone Peer Review Organization (KePRO) - Effective November 1, 2012 | All Long Stay Hospital, Specialized Care, Alzheimer's Assisted Living Waiver, and Technology Assisted Waiver Respite Care Providers Participating in the Virginia Medical Assistance Programs |
| 26-Sep-12 | Contract Award for Service Authorization Administrator and Upcoming Changes for November 1, 2012 | All Outpatient Psychiatric, Outpatient Rehabilitation [including Comprehensive Outpatient Rehabilitation (CORF)], Durable Medical Equipment (DME), Orthotic, Private Duty Nursing, EPSDT Hearing Aid Providers, Audiologists, Home Health, Physicians, Non-Emergency MRI, PET, and CAT Scan, Chiropractic, Prosthetics, Inpatient Acute, Inpatient Psychiatric, and Inpatient Rehabilitation, Treatment Foster Care Case Management, Psychiatric Residential Treatment Facilities, Community Based Residential Services for Children and Adolescent Under Age 21 (Level A Group Homes), Therapeutic Behavioral Services (Level B Group Homes), Community Mental Health Rehabilitation Services (CMHRS), Home and Community Based Care Waiver, Specialized Care, Long Stay Hospital, Alzheimer’s Assisted Living Waiver, Community Services’ Boards, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 12-Sep-12 | Entry of Anthem HealthKeepers Plus for Medicaid/FAMIS Programs into City of Lynchburg, and the Counties of Amherst, Campbell, and Appomattox - November 1, 2012 | All Medicaid Enrolled Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 29-Aug-12 | Enrollment Change for the Children’s Mental Health Program - Effective October 1, 2012 | Transition Coordinators and Case Managers Participating in the Virginia Medical Assistance Programs |
| 23-Jul-12 | Entry of Anthem HealthKeepers Plus, a Virginia Managed Care Organization (MCO), for the Medicaid/FAMIS Programs in Culpeper – September 1, 2012 | All Medicaid Enrolled Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 18-Jul-12 | Termination of the MEDALLION PCCM Program - Effective April 30, 2012 | All Medicaid Enrolled Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 27-Jun-12 | Update on the Virginia Independent Clinical Assessment Program | Providers of Community Mental Health and Substance Abuse Services and Managed Care Organizations |
| 18-Jun-12 | HIV/AIDS Waiver Expiration — Effective June 30, 2012 | All Medicaid Enrolled Providers of Home and Community-Based Waiver Services and Pre-Admission Screening Teams |
| 13-Jun-12 | Updates to the Medicaid Reimbursement Process for Hospital Acquired Conditions (HACs) – Effective July 1, 2012 | Fee-for-service In-State and Out-of-State Hospitals, Including Freestanding Psychiatric Hospitals and State Mental Facilities, and Managed Care Organizations Participating in the Virginia Medical Assistance Program |
| 12-Jun-12 | No Inflation Adjustment for Home Health Providers — Effective July 1, 2012 | All Home Health Providers Participating in the Virginia Medical Assistance Programs and Managed Care Organizations |
| 12-Jun-12 | No Inflation Adjustment for Outpatient Rehabilitation Agencies — Effective July 1, 2012 through June 30, 2014 | All Medicaid Outpatient Rehabilitation and Providers Participating in the Virginia Medical Assistance Program, Managed Care Organizations, and Holders of the Rehabilitation Medicaid Provider Manual |
| 12-Jun-12 | SFY 2013 Rate Change for EPSDT and Home and Community Based Care Waiver Services — Effective July 1, 2012 | All Mental Health/Mental Retardation Providers, Providers of EPSDT Personal Care Services, and Managed Care Organizations |
| 12-Jun-12 | Fee-For-Service Ambulance Service and Mileage Rate Adjustment — Effective July 1, 2012 | All Fee-For-Service Emergency Ground Ambulance, Emergency Air Ambulance, Neonatal Ambulance Service Providers, and Managed Care Organizations that Participate in the Virginia Medical Assistance Program |
| 12-Jun-12 | Reimbursement Rate Change for Targeted Case Management Services in the Early Intervention Program — Effective July 1, 2012 | All Providers of Early Intervention Services Participating in the Virginia Medical Assistance Program and Managed Care Organizations |
| 11-Jun-12 | Provider Aide Record (DMAS-90) Revision | All Medicaid Enrolled Providers of Agency-Directed Personal Care and Respite Care Services and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 8-Jun-12 | Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program and New Drug Utilization Review (DUR) Board Approved Service Authorization (SA) Requirements — Effective July 1, 2012 | All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs |
| 1-May-12 | Changes to Virginia Medicaid Billing Instructions for UB Claims for Inpatient Residential Treatment and Intermediate Care Facilities - June 1, 2012 | Intermediate Care Facility and Inpatient Residential Treatment Facility Providers Participating in the Virginia Medical Assistance Programs |
| 4-Apr-12 | Entry of Managed Care Organizations (MCOs) for the Medicaid/FAMIS Programs in Far Southwest Virginia – July 1, 2012 | All Medicaid Enrolled Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 9-Mar-12 | Services Currently Reviewed by DMAS Medical Support Unit Moving to KePRO for Review and New Procedure Codes Requiring Service Authorization Effective, April 1, 2012 | All In State Hospitals, Rehab Hospitals, Physicians, Nurse Practitioners, Chiropractors, Podiatrists, Optometrists, Opticians, Dentists, Dental Clinics, Ambulatory Surgical Centers, Health Departments, Federally Qualified Health Centers, Rural Health Clinics, Prosthetics Providers, Independent Labs, Out of State Rehab Providers, Out of State DME/Supply Providers, Out of State Hospitals, Out of State Physicians, Out of State Dental Providers, and Out of State Lab Providers Participating in the Virginia Medical Assistance Programs |