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Action:
Amendment to Rule 14 (16 VAC 30-50-150)
Stage: Emergency/NOIRA
16VAC30-50-150

16VAC30-50-150. Rule 14. Definition of community.

For the purpose of § 65.2-605 of the Code of Virginia, the word "community" shall mean one or more planning districts as set forth below. groups of three-digit Virginia zip codes as follows:

Community Planning District(s)

1

Districts 1 and 2

2

District 3

3

District 4

4

District 5

5

Districts 11 and 13

6

District 12

7

District 6

8

District 7

9

District 16

10

Districts 9 and 10

11

District 8

12

Districts 17 and 18

13

Districts 22 and 23

14

Districts 14 and 15

15

District 19

Whenever an employee receives treatment outside of the Commonwealth, the commission will determine the appropriate community in the state or territory where the treatment is rendered upon application of either the employee, employer (or its representative), or medical provider.

When the commission deems appropriate, it may consider additional data to determine the prevailing community rate.

COMMUNITY

THREE-DIGIT ZIP CODES

1 – Northern

201, 220, 221, 222, 223

2 – Northwest

224, 225, 226, 227, 228, 229, 244

3 – Central

230, 231, 232, 238, 239

4 – Eastern

233, 234, 235, 236, 237

5 – Southwest

240, 241, 242, 243, 244, 245, 246

Pursuant to subsection G of § 65.2-605.1 of the Code of the Virginia, the community applicable to services rendered by a health care provider outside of the Commonwealth of Virginia shall be deemed to be that associated with the principal place of business of the employer if located in the Commonwealth of Virginia, or if no such location exists, then that associated with the location where the commission hearing regarding a dispute involving those services is conducted.

The commission may consider additional data to determine the prevailing community rate when appropriate.