# 12 Va. Admin. Code § 30-120-395: 12VAC30-120-395. Preauthorized, emergency, and post-stabilization services and payment rate for care provided by out-of-network providers

> Virginia · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_395

## Section

- **Citation:** 12 Va. Admin. Code § 30-120-395
- **Heading:** 12VAC30-120-395. Preauthorized, emergency, and post-stabilization services and payment rate for care provided by out-of-network providers
- **Jurisdiction:** Virginia
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Virginia Administrative Code / Title 12 Health / Agency 30 Department of Medical Assistance Services / Chapter 120 / 12VAC30-120-395

## Text

The MCOs shall pay for preauthorized, emergency, and post-stabilization services to members in compliance with the contract and 42 CFR 438.114. Preauthorized, emergency, and post-stabilization services provided to a managed care member by a provider or facility not participating in the MCO's network will be reimbursed according to the current Medicaid fee schedule. This reimbursement shall be considered payment in full to the provider or facility of emergency services.

## Nearby sections

- [12 Va. Admin. Code § 30-120-360 12VAC30-120-360. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_360.md)
- [12 Va. Admin. Code § 30-120-370 12VAC30-120-370. Medallion mandatory managed care members](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_370.md)
- [12 Va. Admin. Code § 30-120-380 12VAC30-120-380. Medallion MCO responsibilities](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_380.md)
- [12 Va. Admin. Code § 30-120-390 12VAC30-120-390. Payment rate for MCOs](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_390.md)
- [12 Va. Admin. Code § 30-120-395 12VAC30-120-395. Preauthorized, emergency, and post-stabilization services and payment rate for care provided by out-of-network providers](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_395.md)
- [12 Va. Admin. Code § 30-120-400 12VAC30-120-400. Quality control and utilization review](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_400.md)
- [12 Va. Admin. Code § 30-120-410 12VAC30-120-410. Sanctions](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_410.md)
- [12 Va. Admin. Code § 30-120-420 12VAC30-120-420. Member grievances and appeals](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_420.md)
- [12 Va. Admin. Code § 30-120-430 12VAC30-120-430. Provider grievances, reconsiderations, and appeals](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_430.md)
- [12 Va. Admin. Code § 30-120-600 12VAC30-120-600. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_600.md)
- [12 Va. Admin. Code § 30-120-610 12VAC30-120-610. CCC Plus mandatory managed care members enrollment process](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_610.md)
- [12 Va. Admin. Code § 30-120-615 12VAC30-120-615. CCC Plus providers; Medicaid enrollment process](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_615.md)
- [12 Va. Admin. Code § 30-120-620 12VAC30-120-620. MCO responsibilities; sanctions](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_620.md)
- [12 Va. Admin. Code § 30-120-625 12VAC30-120-625. Continuity of care](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_625.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_120_395. Check the current official text before relying on it. Not legal advice.