Selected “Outpatient” Rates Increase Today!

July 01, 2019

DMAS did send out a Bulletin on 21 June, 2019 which included the following:

Psychiatric Services Rate Increase
In accordance with Item 303.DDDD of the 2019 Acts of Assembly, DMAS increased practitioner rates for psychiatric services to reflect 100% of the 2018 Medicare rates. DMAS created a separate service category for psychiatric services, adjusted rates to reflect changes in relative value units (RVUs) in a budget neutral exercise and increased rates 21%. As a result of the adjustment for changes in RVUs, the actual increase by procedure code varies and reflects 100% of the 2018 Medicare rates. Rates for new services were also increased. This increase affects all providers of these services. In accordance with 12VAC 30-80-30(3), physicians are paid 100% of the Medicaid rate, psychologists are paid 90% of the Medicaid rate and other authorized practitioners are paid 75% of the psychologist rate.

We used their formula to assemble a table which may be useful for selected rates!