Virginia
This data is meant to be used for educational purposes to inform providers, patients, insurers, and state Medicaid agencies what genetic services may or may not be written into each state’s Medicaid policy. The database is not meant to indicate or imply whether a certain program will cover a specific service, since many decisions are made on a case by case basis. If you have specific questions about whether a service is covered, you should reach out to your plan administrator. Please see this disclaimer below for more information.
Medicaid Coverage Information Published
State Contact Information
Cheryl Roberts
Deputy Director of Programs and Operations
General Genetic Testing Criteria
Genetic Testing Not Covered
State Specific Definition
Genetic Services for Children
Genetic Counseling Requirement
Metabolic Formula Coverage Legislation
Metabolic Formula Coverage & Criteria
Prior Authorization Requirements
Prior Authorization Forms
Fee Schedule
BRCA Testing Coverage
Requirements for BRCA
Cystic Fibrosis Screening
Hereditary Cancer Testing Coverage
Lynch Syndrome Testing Coverage
Microarray Testing
Newborn Screening
Panel Testing
Pharmacogenetic Testing
Prenatal Testing Offered
Whole Exome Sequencing
Other Tests Covered
Other Information
Sickle Cell Screening Program: Sickle cell screening is offered through local Health Departments in both family planning and maternity clinics. We encourage parents whose newborn has been identified with sickle cell disease or trait to be tested. To see if you qualify for free screening, please contact your local health department.
Resources
- Provider Manual Durable Medical Equipment and Supplies Manual Chapter IV Covered Services and Limitations
- https://www.virginiamedicaid.dmas.virginia.gov/wps/portal/ProviderManual
- Sickle Cell Screening Program
- http://www.vdh.virginia.gov/sickle-cell-programs/services/
- https://www.ecm.virginiamedicaid.dmas.virginia.gov/WorkplaceXT/getContent?impersonate=true&id=%7BB00CF05C-0000-C420-831D-F6883978FBA0%7D&vsId=%7BAE8AE2CE-115A-49A8-BA43-8534F3123152%7D&objectType=document&objectStoreName=VAPRODOS1
Newborn Screening Reimbursement
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Disclaimer: The information contained in the database has been obtained from sources believed to be reliable but NCC has not attempted to validate or confirm the information. The database may be updated periodically. However, the accuracy and completeness of the information contained in the database cannot be, and is not, guaranteed. NCC makes no warranty of the accuracy, completeness or timeliness of this information, and shall not be liable for any decision made in reliance on this information. It is the user’s responsibility to verify this information by contacting the state Medicaid agency directly.
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