Final Text
The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:
"Commission" means the Virginia Workers' Compensation Commission.
"Community" means one of the six medical communities as defined in § 65.2-605 A of the Code of Virginia.
"Ground rules" means:
1. For medical services rendered during the period from January 1, 2018, through December 31, 2019, means the 2018 Medical Fee Schedule Ground Rules adopted by the commission on June 13, 2017, and revised on November 14, 2017 July 18, 2019, incorporated by reference in this chapter and available on the commission's website at http://www.workcomp.virginia.gov/content/virginia-medical-fee-schedules-ground-rules https://www.workcomp.virginia.gov/documents/2018-mfs-ground-rules.
2. For medical services rendered during the period from January 1, 2020, through December 31, 2021, means the 2020 Medical Fee Schedule Ground Rules adopted by the commission on July 18, 2019, and revised on October 17, 2019, incorporated by reference in this chapter and available on the commission's website at http://www.workcomp.virginia.gov/content/virginia-medical-fee-schedules-ground-rules https://www.workcomp.virginia.gov/documents/2020-medical-fee-schedules-ground-rules.
3. For medical services rendered during the period from January 1, 2022, through December 31, 2023, means the 2022 Medical Fee Schedule Ground Rules adopted by the commission on June 29, 2021, incorporated by reference in this chapter and available on the commission's website at http://websiteqa/documents/2022-medical-fee-schedules-ground-rules https://www.workcomp.virginia.gov/documents/2022-medical-fee-schedules-ground-rules.
4. For medical services rendered during the period from January 1, 2024, through December 31, 2025, means the 2024 Medical Fee Schedule Ground Rules adopted by the commission on August 17, 2023, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/medical-fee-services/2024-medical-fee-schedules-ground-rules.
"Medical services" means any medical, surgical, or hospital service required to be provided to an injured person pursuant to Title 65.2 of the Code of Virginia, exclusive of a medical service provided in the treatment of a traumatic injury or serious burn as those terms are defined in § 65.2-605 A of the Code of Virginia.
"Virginia fee schedules" means:
1. For medical services rendered during the period from January 1, 2018, through December 31, 2019, means the 2018 Medical Fee Schedules adopted by the commission on June 13, 2017, and revised on November 14, 2017, incorporated by reference in this chapter and available on the commission's website at http://www.workcomp.virginia.gov/content/virginia-medical-fee-schedules https://www.workcomp.virginia.gov/content/2018-medical-fee-schedule.
2. For medical services rendered during the period from January 1, 2020, through December 31, 2021, means the 2020 Medical Fee Schedules adopted by the commission on July 18, 2019, and revised on October 17, 2019, incorporated by reference in this chapter and available on the commission's website at http://www.workcomp.virginia.gov/content/virginia-medical-fee-schedules https://www.workcomp.virginia.gov/content/2020-virginia-medical-fee-schedules.
3. For medical services rendered during the period from January 1, 2021 2022, through December 31, 2022 2023, means the 2022 Medical Fee Schedules adopted by the commission on June 29, 2021, incorporated by reference in this chapter and available on the commission's website at http://websiteqa/content/2022-virginia-medical-fee-schedules https://www.workcomp.virginia.gov/content/2022-virginia-medical-fee-schedules.
4. For medical services rendered during the period from January 1, 2024, through December 31, 2025, means the 2024 Medical Fee Schedules adopted by the commission on August 17, 2023, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/medical-fee-services/2024-medical-fee-schedules.
A. The Virginia fee schedules and ground rules shall apply to all medical services rendered on or after January 1, 2018, regardless of the date of injury.
B. The applicable community for providers of medical services rendered in the Commonwealth shall be determined by the zip code of the location where the services were rendered. C. The applicable community for providers of medical services rendered outside of the Commonwealth shall be determined by the zip code of the principal place of business of the employer if located in the Commonwealth or, if no such location exists, then the zip code of the location where the commission hearing regarding a dispute concerning the services would be conducted.
2018 Virginia Workers' Compensation Medical Fee Schedules, adopted June 13, 2017, revised November 14, 2017, Virginia Workers' Compensation Commission, http://www.workcomp.virginia.gov/content/virginia-medical-fee-schedules https://www.workcomp.virginia.gov/content/2018-medical-fee-schedule
2020 Virginia Workers' Compensation Medical Fee Schedules adopted July 18, 2019, and revised on October 17, 2019, Virginia Workers' Compensation Commission, http://www.workcomp.virginia.gov/content/virginia-medical-fee-schedules https://www.workcomp.virginia.gov/content/2020-virginia-medical-fee-schedules
2022 Medical Fee Schedules adopted June 29, 2021, Virginia Workers' Compensation Commission, http://websiteqa/content/2022-virginia-medical-fee-schedules https://www.workcomp.virginia.gov/content/2022-virginia-medical-fee-schedules
2024 Medical Fee Schedules adopted August 17, 2023, Virginia Workers' Compensation Commission, https://www.workcomp.virginia.gov/medical-fee-services/2024-medical-fee-schedules