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Claims Processing
Tools and information for claims processing are found here.
NOTE: Effective as of July 2009 dates of service and on-going, Medicaid rates paid to some providers will be reduced by 2%. The reduction will be captured in the last step of claims processing and is not reflected in the rates posted here. The remittance advice (RA) will state that the payment is a reduced amount of 2% from the posted DVHA fee schedules.
Fee Schedules: Definitions; CDT Codes; CPT Codes; Evaluation & Management (E & M); Durable Medical Equipment (DME); J Codes; HCPCS; Lab; Ladies First; PAC 8 & 9; Vision
2012 Fee Schedules (coming soon)
OPPS Fee Schedules: Hospital Based Services for Out-Patient Billers
2012 OPPS Fee Schedules (coming soon)
Radiology / OPPS Radiology (MedSolutions/Prior Authorization)
ICD9 Surgical Codes Requiring Prior Authorization
- Web Version (04/03/2009)
- Excel Version (04/03/2009)
Dental Procedure/Fee Schedule
- January 1, 2011 (For services provided beginning 01/01/11) (Posted 05/23/11)
- June 5, 2009 (For services provided beginning 6/5/09) (rev. 06/26/2009)(rev. 12/21/2010)
- July 1, 2008 (For services provided from 7/1/08 through 6/4/09)
- January 1, 2008 (For services provided from 1/1/08 through 6/30/08)
Transportation Fee Schedule
Note: CPT and CDT codes, descriptions and other data only are copyright 2010 American Medical Association (AMA) and American Dental Association (ADA), respectively. All rights reserved. CPT is a registered trademark of the AMA. CDT is a registered trademark of the ADA. Applicable FARS and DFARS Restrictions apply to government use. Fee schedules, relative value units, conversion factora and/or related components are not assigned by the AMA or ADA, are not part of the CPT or CDT, and the AMA and ADA are not recommending their use. The AMA and ADA do not directly or indirectly practice medicine or dispense medical services. The AMA and ADA assume no liability for data contained or not contained herein.
