Virginia denial decoder
Diagnosis code or modifier mismatch
Virginia doula claim lines should use diagnosis Z32.2 and the HD modifier for the encoded service lines.
Denial guidance uses state billing sources.
Next actions avoid reimbursement guarantees.
Source trail remains visible for review.
Diagnosis code or modifier mismatch
Virginia doula claim lines should use diagnosis Z32.2 and the HD modifier for the encoded service lines.
Next action
Confirm the line is a Virginia Medicaid doula service and correct the diagnosis or modifier before submission.
Back to Virginia rulesWhy this page exists
Denial pages use the same checked state sources as the app.
Virginia DMAS Procedure Fee Files & CPT CodesVirginia Department of Medical Assistance Services · Procedure fee files updated June 11, 2026; DOULA rows: 99600/59425/59430 at $14.99 per 15-minute unit, 59409/59514 at $350, 99199 incentive at $50 · checked 2026-06-13Virginia DMAS Community Doula ProgramVirginia Department of Medical Assistance Services · Provider certification, NPI, Medicaid enrollment, liability insurance, MCO contracting, licensed-practitioner recommendation, no prior authorization, eligibility, and training resources · checked 2026-06-13DMAS Bulletin: Maternal Health Bills and Budget Items Effective July 1, 2025Virginia Department of Medical Assistance Services · Postpartum doula visits increased 4 to 6, coverage window extended to 12 months postpartum, and 59430-HD with diagnosis Z32.2 identified · checked 2026-06-13Virginia SPA 21-013 Doula ServicesVirginia Department of Medical Assistance Services / CMS · State plan authority for doula benefit, visit-unit structure, incentives, and published fee-schedule method · checked 2026-06-13