Chapter 100 - General Information Effective September 1, 2003 and revised January 1, 2005
Chapter 200 - Definitions Effective September 1, 2003
Chapter 300 - Provider Participation Requirements Effective September 1, 2003 and revised March 1, 2007
Chapter 400 - Member Eligibility Effective April 1, 2022
Chapter 400 - Member Eligibility Effective April 1, 2020
Chapter 400 Member Eligibility Effective December 1, 2015
Chapter 400 Public Comments and Responses Effective December 1, 2015
Chapter 400 - Member Eligibility Effective October 1, 2003 and revised January 1, 2005
Chapter 500 - Lab and Radiology Effective July 1, 2004 and revised January 1, 2005
Chapter 501 Aged and Disabled Waiver Effective April 1, 2021
Chapter 501 Public Comments and Responses Effective April 1, 2021
Chapter 501 Aged and Disabled Waiver Effective January 1, 2019
Chapter 501 Public Comments and Responses Effective January 1, 2019
Chapter 501 - Aged & Disabled Waiver Effective November 1, 2003 and revised January 1, 2008
Chapter 501 - Aged & Disabled Waiver Effective September 1, 2011 and revised June 1, 2014
Chapter 502 - Children with Serious Emotional Disorders Waiver Effective July 1, 2021
Chapter 502 - Public Comments and Responses Effective July 1, 2021
Chapter 502 - Children with Serious Emotional Disorders Waiver Effective March 1, 2020
Chapter 502 Public Comments and Responses Effective March 1, 2020
Chapter 502 - Behavioral Health Clinic Effective July 1, 2004 and revised January 1, 2006
Chapter 502 - Behavioral Health Clinic Effective July 1, 2014
Chapter 502 - Behavioral Health Clinic Replaced by Chapter 503 - Licensed Behavioral Health Center Services Effective July 15, 2018
Chapter 503 - Behavioral Health Rehabilitation Effective July 1, 2004 and revised January 1, 2006
Chapter 503 - Behavioral Health Rehabilitation Effective July 1, 2014
Chapter 503 - Behavioral Health Rehabilitation Replaced by Chapter 503 - Licensed Behavioral Health Center Services Effective July 15, 2018
Chapter 504 - Substance Use Disorder Services Effective October 1, 2020
Chapter 504 - Public Comments and Answers Effective October 1, 2021
Chapter 504 - Substance Use Disorder Services Effective July 1, 2019
Appendix B - Application for Residential Services Effective July 1, 2019
Chapter 504 - Substance Use Disorder Services Effective July 1, 2018
Chapter 504 - Substance Use Disorder Services Public Comments and Answers July 1, 2018
Appendix A - Documentation for Peer Recovery Support Services Effective July 1, 2018
Appendix B - Application for Residential Services Effective July 1, 2018
Appendix B - Application for Residential Services Effective September 7, 2018
Chapter 504 - Substance Use Disorder Services Effective January 14, 2018
Chapter 504 - Substance Use Disorder Services Public Comments and Answers Effective January 14, 2018
Chapter 504 - Public Comments and Answers Effective July 1, 2018
Chapter 504 - Chiropractic Services Effective October 1, 2005
Chapter 505 - Dental Services Effective November 1, 2010
Chapter 505 - Dental Services Effective January 16, 2012
Chapter 505 - Dental Services Effective May 25, 2016
Chapter 505 Oral Health Services Effective October 1, 2019
Appendix 505A Oral Health Services for Children Under Age 21 Effective January 1, 2020
Appendix 505A Oral Health Services for Children Under Age 21 Effective November 1, 2024
Chapter 506 - DME/Medical Supplies Effective May 1, 2005 and revised January 1, 2008
Appendix 506A Covered DME Supplies Effective October 1, 2015 to January 1, 2016
Appendix 506B Covered O and P Supplies Effective October 1, 2015 to January 1, 2016
Appendix 506C Non-covered DMEPOS Supplies Effective October 1, 2015 to January 1, 2016
Chapter 507 - ASC & Birthing Centers Effective June 1, 2005 revised February 15, 2006
Chapter 508 - Home HealthEffective July 1, 2004 and last revised on July 1, 2010
Chapter 509 - Hospice Services July 1, 2004
Chapter 509 - Hospice Services May 1, 2014
Chapter 510 - Hospital Services Effective July 1, 2004 and revised on January 12, 2006
Chapter 511 - ICF/IID Effective June 6, 2016
Chapter 511 - ICF/MR Services Effective July 1, 2004
Chapter 512-Traumatic Brain Injury Waiver Effective April 1, 2021
Chapter 512 Public Comments and Responses Effective April 1, 2021
Chapter 512 Traumatic Brain Injury Waiver Effective January 1, 2019
Chapter 512 Public Comments and Responses Effective January 1, 2019
Chapter 512 - Traumatic Brain Injury Waiver Effective February 1, 2012 and revised Feb 1, 2013
Chapter 513 - IDDW Services Effective April 1, 2021
Chapter 513 Public Comments and Responses Effective April 1, 2021
Chapter 513 - IDD Waiver Services Effective December 1, 2015
Chapter 513 - IDD Waiver Services Effective October 1, 2011
Chapter 513 - IDD Waiver Services Effective November 1, 2007
Chapter 513 - MR/DD Waiver Services Effective December 1, 2004 and revised January 1, 2009
Chapter 513 Intellectual and Developmental Disabilities Waiver (IDDW) Effective February 1, 2018
Chapter 513 Public Comments and Responses Effective February 1, 2018
Chapter 513 West Virginia Behavioral Health Care Providers Association (WVBHPA) CommentsEffective February 1, 2018
Chapter 514 - Nursing Facility Services Effective July 1, 2020
Chapter 514 - Nursing Facility Services Effective January 1, 2005 and revised April 10, 2010
Chapter 515 - Occupational/Physical Therapy Effective July 1, 2004 and revised May 1, 2005
Chapter 515 Occupational Therapy and Physical Therapy Effective Date July 1, 2019
Chapter 515 Public Comments and Responses Effective Date July 1, 2019
Chapter 516 - Orthotic & Prosthetic Services Effective March 1, 2007 and revised January 1, 2008
Chapter 517 - Personal Care Effective January 1, 2014
Chapter 518 - Pharmacy Services Effective April 17, 2006 and revised November 1, 2010
Chapter 518 - Pharmacy Services Effective January 1, 2010 to November 1, 2013
Chapter 518 - Pharmacy Services Effective July 20, 2018
Chapter 518A Physician Administered Drugs Effective July 20, 2018
Chapter 518 Pharmacy Services Effective December 1, 2020
Chapter 519 - Practitioner ServicesJuly 1, 2005 and revised January 16, 2012
Policy 519.7 Chiropractic ServicesEffective January 15, 2016
Policy 519.8 Evaluation and Management Effective May 18, 2018
Policy 519.8 Evaluation and Management Public Comments and Responses Effective May 18, 2018
Policy 519.13 Podiatry Services Effective January 15, 2016
Policy 519.15 Reproductive Health Services Effective January 15, 2016
Policy 519.15 Reproductive Health Services Effective July 1, 2020
Policy 519.17 Telehealth Services Effective January 15, 2016
Policy 519.17 Telehealth Services Effective March 1, 2020
Policy 519.17 Telehealth Services Appendix A - Medicaid Telehealth Standard Codes Effective December 31, 2024
Policy 519.17 Telehealth Services Appendix A - Medicaid Telehealth Standard Codes Effective April 1, 2024
Policy 519.17 Telehealth Services Appendix B - Public Health Emergency Medicaid Telehealth Services Flexibilities Effective August 1, 2023
Policy 519.18 Tobacco Cessation Services Effective March 16, 2023
Policy 519.18 Tobacco Cessation ServicesEffective March 1, 2020
Policy 519.18 Tobacco Cessation Services Effective January 15, 2016
Policy 519.19 Women's Health Services Effective August 30, 2019
Policy 519.23 Applied Behavior Analysis Effective September 1, 2018
Policy 519.23 Applied Behavior Analysis Public Comments and AnswersEffective September 1, 2018
Policy 519.24 Gender Affirmation Surgery Effective September 1, 2022
Policy 519.24 Public Comments and ResponsesEffective September 1, 2022
Policy 519.3 Antigen and Allergy Services Valid January 15, 2016 to February 19, 2016
Chapter 520 - Podiatry ServicesEffective July 1, 2004 and revised February 15, 2006
Chapter 521 - Psychological Services Effective September 1, 2003 and revised January 1, 2006
Policy 521B - Drug-Free Mom and Baby Programs Effective January 1, 2022
Policy 521B - Public Comments and Responses Effective January 1, 2022
Chapter 522 - RHC FQHC Services Effective July 1, 2004
Chapter 522 - FQHCRHC Services Effective December 1, 2015
Chapter 522 - FQHCRHC Public Comments and Responses Effective December 1, 2015
Chapter 523 - Targeted Case Management Effective May 1, 2004 and revised January 1, 2006
Chapter 524 - TransportationEffective September 1, 2003 and revised September 15, 2005
Chapter 524 - Transportation Effective September 18, 2015
Chapter 524 - Transportation Effective September 1, 2020
Chapter 525 - Vision Services Effective September 1, 2003 and revised April 14, 2006
Chapter 525 - Vision Services Effective October 1, 2015
Chapter 525 - Vision Services Effective September 1, 2016
Chapter 526 - Children with Disabilities Community Services Program (CDCSP)September 1, 2008
Chapter 527 - Mountain Health Choices Effective January 30,2009 and Retired September 2011
Chapter 527 Mountain Health Trust (Managed Care) Effective April 1, 2018
Chapter 527 Public Comments and Answers Effective April 1, 2018
Chapter 528 - Radiology Services Effective September 15, 2018
Chapter 528 - Radiology Services Effective October 2, 2015
Chapter 528 - Radiology Services Public Comments and Responses Effective October 2, 2015
Chapter 528 - Radiology Services Effective January 1, 2010
Radiology Services Requiring Prior Authorization Effective January 1, 2013
Policy 528.4 Mammography Effective April 24, 2019
Chapter 529 - Laboratory Services Effective January 1, 2010
Laboratory Services regarding prior authorization Effective August 5, 2013
Policy 529.2 Drug Screenings Effective January 1, 2017
Policy 529.2 Drug Screenings Public Comments Effective January 1, 2017
Chapter 530 - Speech and Audiology Services Effective January 1, 2012
Chapter 531 - Psychiatric Residential Treatment Facility Services Effective March 23, 2015
Chapter 531 - Psychiatric Residential Treatment Facility Services Public Comments and Responses Effective October 6, 2015
Chapter 531 - Psychiatric Residential Treatment Facility Services Effective May 1, 2013
Chapter 532 - Private Duty Nursing Effective December 21, 2016
Chapter 532 - Private Duty Nursing Effective September 1, 2012
Chapter 532 - Private Duty Nursing Effective September 15, 2015
Chapter 532 - Private Duty Nursing Program Instruction January 1, 2000
Chapter 537 - Licensed Independent Clinical Social Worker (LICSW) Effective January 15, 2018
Chapter 538 - School Based Health ServicesEffective August 1, 2015 to August 1, 2017
Chapter 538 - School-Based Health Services Public Comments and Answers Effective August 1, 2015
Chapter 538 School Based Health ServicesEffective August 1, 2017
Chapter 538 Public Comments and Responses Effective August 1, 2017
Appendix 538A Nursing Billing Form Effective August 1, 2015
Appendix 538B Audiological Billing Form Effective August 1, 2015
Appendix 538C Speech Therapy Billing Form Effective August 1, 2015
Appendix 538D Psychological Billing Form Effective August 1, 2015
Appendix 538E Personal Care Medicaid Log Effective August 1, 2015
Appendix 538F Occupational Therapy Billing Form Effective August 1, 2015
Appendix 538G Physical Therapy Billing Form Effective August 1, 2015
Appendix 538H Targeted Case Management Form Effective August 1, 2015
Appendix 538I Transportation Billing Form Effective August 1, 2015
Chapter 539 - Local Health Departments Effective July 1, 2016
Chapter 539 - Local Health Departments Public Comments and Responses Effective July 1, 2016
Chapter 600 - Reimbursement Methodologies Effective September 1, 2003 and revised January 1, 2006
Chapter 800 (B) - Program IntegrityEffective December 1, 2012
Chapter 800 - General Administration Effective January 1, 2009
Chapter 900 - Estate Recovery Effective July 2008
