Statutes, codes, and regulations
Virginia Administrative Code
Title 12 - HEALTHAgency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICESChapter 50 - AMOUNT, DURATION, AND SCOPE OF MEDICAL AND REMEDIAL CARE SERVICES
Part III - Amount, Duration, and Scope of Services
Section 12VAC30-50-180 - Clinic services

12 Va. Admin. Code § 30-50-180

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Current through Register Vol. 41, No. 9, December 16, 2024
Section 12VAC30-50-180 - Clinic services
A. Reimbursement for induced abortions is provided in only those cases in which there would be a substantial endangerment of life to the mother if the fetus were carried to term.
B. Clinic services means preventive, diagnostic, therapeutic, rehabilitative, or palliative items or services that:
1. Are provided to outpatients;
2. Are provided by a facility that is not part of a hospital but is organized and operated to provide medical care to outpatients; and
3. Except in the case of nurse-midwife services, as specified in 42 CFR 440.165, are furnished by or under the direction of a physician or dentist.
C. Reimbursement to community mental health clinics for psychotherapy services is provided only when performed by a qualified therapist. For purposes of this section, a qualified therapist is:
1. A licensed physician who has completed three years of post-graduate residency training in psychiatry; or
2. An individual licensed by one of the boards administered by the Department of Health Professions to provide psychotherapy services including:
(i) a licensed clinical psychologist;
(ii) a LMHP-RP, as defined in 12VAC30-50-130;
(iii) a licensed psychiatric nurse practitioner;
(iv) a licensed clinical social worker;
(v) a LMHP-S, as defined in 12VAC30-50-130;
(vi) a licensed professional counselor;
(vii) a LMHP-R, as defined in 12VAC30-50-130;
(viii) a clinical nurse specialist-psychiatric;
(ix) a licensed marriage and family therapists.
D. Addiction and recovery treatment services shall be covered in clinics consistent with 12VAC30-130-5000 et seq.

12 Va. Admin. Code § 30-50-180

Derived from VR460-03-3.1100 §9, eff. July 1, 1989; amended, eff. September 1, 1993; Virginia Register Volume 10, Issue 22, eff. September 1, 1994; Volume 16, Issue 19, eff. July 5, 2000; Volume 20, Issue 19, eff. July 1, 2004; Volume 26, Issue 8, eff. January 21, 2010; Volume 26, Issue 19, eff. July 1, 2010; Amended, Virginia Register Volume 33, Issue 12, eff. 4/1/2017; Amended, Virginia Register Volume 35, Issue 05, eff. 12/13/2018.

Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.