Virginia Medicaid rate for CPT 12001
Virginia Medicaid pays $98.67 for CPT 12001 in its October 2026 fee-for-service schedule: the 11th-highest of 45 state Medicaid programs, at 114% of the $86.45 median.
- Non-facility rate
- $98.67
- Rank
- 11 of 45
- vs. state median
- 114%
- vs. VA Medicare
- 76-89%
What Virginia Medicaid publishes for 12001
11th-highest of 45 · 114% of median
- Schedule
- October 2026
- In effect since
- Jul 1, 2026
- Prior authorization
- Not required
1 rate type
- Under 21 and 1 more
- Facility $38.19
Unmodified non-facility fee-for-service rate from the state's published file. Managed-care contracts, supplemental payments, and claim-specific adjustments can change what is paid. DMAS Procedure Fee Files
12001 in neighboring states
Each state's comparable non-facility rate for 12001 in its current schedule.
| State | Rate | vs. Virginia |
|---|---|---|
| Kentucky | $64.92 | -34% |
| Maryland | $88.44 | -10% |
| North Carolina | $104.41 | +6% |
| West Virginia | $76.86 | -22% |
12001 in every state
Map and ranking of every state program that prices 12001.
Compare 12001 across states12001 under Medicare
Medicare's 2026 non-facility payment for 12001 in Virginia is $110.76 to $130.38 across its 2 payment localities; Virginia Medicaid's rate is 76-89% of that. The national amount before geographic adjustment is $113.897.
See 12001 Medicare ratesSee Virginia's full schedule: all 8,748 codes, every published period, and commercial payer rates for 12001.
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