Virginia denial decoder
Newborn incentive may need newborn Medicaid ID
The newborn postpartum incentive can require billing under the newborn Medicaid ID.
Denial guidance uses state billing sources.
Next actions avoid reimbursement guarantees.
Source trail remains visible for review.
Newborn incentive may need newborn Medicaid ID
The newborn postpartum incentive can require billing under the newborn Medicaid ID.
Next action
Confirm the payer route and newborn Medicaid ID before submitting the newborn incentive line.
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