{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3408.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3408.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3408.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3408.html"}],"law_id":87046,"edition_id":1,"section_id":87046,"structure_id":14324,"section_number":"38.2-3408","catch_line":"Policy providing for reimbursement for services that may be performed by certain practitioners other than physicians","history":"1968, c. 588, \u00a7 38.1-347.1; 1973, c. 428; 1979, c. 13; 1986, c. 562; 1987, cc. 549, 551, 557; 1989, cc. 7, 201; 1997, c. 203; 1998, c. 146; 2001, cc. 102, 475; 2019, cc. 332, 333; 2020, cc. 726, 731; 2022, cc. 440, 441; 2023, c. 183; 2025, c. 695.","full_text":"A\n\nIf an accident and sickness insurance policy provides reimbursement for any service that may be legally performed by a person licensed in this Commonwealth as a chiropractor, optometrist, optician, professional counselor, psychologist, clinical social worker, podiatrist, physical therapist, chiropodist, clinical nurse specialist, audiologist, speech pathologist, certified nurse midwife or other advanced practice registered nurse, licensed certified midwife, licensed midwife, marriage and family therapist, athletic trainer, or licensed acupuncturist, reimbursement under the policy shall not be denied because the service is rendered by the licensed practitioner, provided that, for services performed by an athletic trainer, such service is performed in an office setting.B\n\nIf an accident and sickness insurance policy provides reimbursement for a service that may be legally performed by a licensed pharmacist, reimbursement under the policy shall not be denied because the service is rendered by the licensed pharmacist, provided that (i) the service is performed for an insured for a condition under the terms of a collaborative agreement, as defined in § 54.1-3300, (ii) the service is for the administration of vaccines for immunization, or (iii) the service is provided in accordance with § 54.1-3303.1.C\n\nThe reimbursement for a service provided by a licensed certified midwife or licensed midwife shall be in the same amount as the reimbursement paid under the policy to a certified nurse midwife for performing such service in the area served, provided that the claim is submitted using (i) the diagnoses and procedure codes applicable to the service; (ii) such licensed certified midwife’s or licensed midwife’s name; (iii) the national provider identifier for the licensed certified midwife or licensed midwife providing the service; and (iv) if required by the insurer, the facility in which the service is provided.D\n\nNo insurer shall reduce the reimbursement paid to a certified nurse midwife in order to comply with the provisions of this section.E\n\nThis section shall not apply to Medicaid, or any state fund.","order_by":null,"text":{"0":{"id":311722,"text":"If an accident and sickness insurance policy provides reimbursement for any service that may be legally performed by a person licensed in this Commonwealth as a chiropractor, optometrist, optician, professional counselor, psychologist, clinical social worker, podiatrist, physical therapist, chiropodist, clinical nurse specialist, audiologist, speech pathologist, certified nurse midwife or other advanced practice registered nurse, licensed certified midwife, licensed midwife, marriage and family therapist, athletic trainer, or licensed acupuncturist, reimbursement under the policy shall not be denied because the service is rendered by the licensed practitioner, provided that, for services performed by an athletic trainer, such service is performed in an office setting.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":311723,"text":"If an accident and sickness insurance policy provides reimbursement for a service that may be legally performed by a licensed pharmacist, reimbursement under the policy shall not be denied because the service is rendered by the licensed pharmacist, provided that (i) the service is performed for an insured for a condition under the terms of a collaborative agreement, as defined in § 54.1-3300, (ii) the service is for the administration of vaccines for immunization, or (iii) the service is provided in accordance with § 54.1-3303.1.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":311724,"text":"The reimbursement for a service provided by a licensed certified midwife or licensed midwife shall be in the same amount as the reimbursement paid under the policy to a certified nurse midwife for performing such service in the area served, provided that the claim is submitted using (i) the diagnoses and procedure codes applicable to the service; (ii) such licensed certified midwife’s or licensed midwife’s name; (iii) the national provider identifier for the licensed certified midwife or licensed midwife providing the service; and (iv) if required by the insurer, the facility in which the service is provided.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":311725,"text":"No insurer shall reduce the reimbursement paid to a certified nurse midwife in order to comply with the provisions of this section.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":311726,"text":"This section shall not apply to Medicaid, or any state fund.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D"}},"ancestry":[{"id":14324,"edition_id":1,"name":"Mandated Benefits","identifier":"2","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:47:45","date_modified":"2026-06-26 03:47:45","permalink":{"id":215143,"object_type":"structure","relational_id":14324,"identifier":"2","token":"38.2\/34\/2","url":"\/38.2\/34\/2\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12993,"edition_id":1,"name":"Provisions Relating to Accident and Sickness Insurance","identifier":"34","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:44:07","date_modified":"2026-06-26 03:44:07","permalink":{"id":214887,"object_type":"structure","relational_id":12993,"identifier":"34","token":"38.2\/34","url":"\/38.2\/34\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":87046,"structure_id":14324,"section_number":"38.2-3408","catch_line":"Policy providing for reimbursement for services that may be performed by certain practitioners other than physicians","url":"\/38.2-3408\/","token":"38.2\/34\/2\/38.2-3408","metadata":false},{"id":55621,"structure_id":14324,"section_number":"38.2-3409","catch_line":"Coverage of dependent children","url":"\/38.2-3409\/","token":"38.2\/34\/2\/38.2-3409","metadata":false},{"id":68501,"structure_id":14324,"section_number":"38.2-3410","catch_line":"Construction of policy generally; words \"physician\" and \"doctor\" to include dentist","url":"\/38.2-3410\/","token":"38.2\/34\/2\/38.2-3410","metadata":false},{"id":76551,"structure_id":14324,"section_number":"38.2-3411","catch_line":"Coverage of newborn children required","url":"\/38.2-3411\/","token":"38.2\/34\/2\/38.2-3411","metadata":false},{"id":71629,"structure_id":14324,"section_number":"38.2-3411.1","catch_line":"Coverage for child health supervision services","url":"\/38.2-3411.1\/","token":"38.2\/34\/2\/38.2-3411.1","metadata":false},{"id":70694,"structure_id":14324,"section_number":"38.2-3411.2","catch_line":"Coverage of adopted children required","url":"\/38.2-3411.2\/","token":"38.2\/34\/2\/38.2-3411.2","metadata":false},{"id":77817,"structure_id":14324,"section_number":"38.2-3411.3","catch_line":"Coverage for childhood immunizations","url":"\/38.2-3411.3\/","token":"38.2\/34\/2\/38.2-3411.3","metadata":false},{"id":86598,"structure_id":14324,"section_number":"38.2-3411.4","catch_line":"Coverage for infant hearing screening and related 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coverage made optional to group policy or contract holder","url":"\/38.2-3419\/","token":"38.2\/34\/2\/38.2-3419","metadata":false},{"id":57559,"structure_id":14324,"section_number":"38.2-3419.1","catch_line":"Report of costs and utilization of mandated benefits","url":"\/38.2-3419.1\/","token":"38.2\/34\/2\/38.2-3419.1","metadata":false}],"next_section":{"id":55621,"structure_id":14324,"section_number":"38.2-3409","catch_line":"Coverage of dependent children","url":"\/38.2-3409\/","token":"38.2\/34\/2\/38.2-3409","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3408\/","history_text":"

This law was first created in 1968. The record of its establishment is cataloged in chapter 588 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1968 \u201cActs\u201d aren\u2019t available online. It has been modified 13 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1973, chapter 428; in 1979, chapter 13; in 1986, chapter 562; in 1987, chapters 549, 551, and 557; in 1989, chapters 7 and 201; in 1997, chapter 203<\/a>; in 1998, chapter 146<\/a>; in 2001, chapters 102<\/a> and 475<\/a>; in 2019, chapters 332<\/a> and 333<\/a>; in 2020, chapters 726<\/a> and 731<\/a>; in 2022, chapters 440<\/a> and 441<\/a>; in 2023, chapter 183<\/a>; in 2025, chapter 695<\/a>.<\/p>","references":[{"id":84333,"section_number":"38.2-3406.1","catch_line":"Application of requirements that policies offered by small employers include state-mandated health benefits","order_by":null,"url":"\/38.2-3406.1\/"},{"id":76321,"section_number":"38.2-3407","catch_line":"Health benefit programs","order_by":null,"url":"\/38.2-3407\/"},{"id":68442,"section_number":"38.2-3407.12","catch_line":"Patient optional point-of-service benefit","order_by":null,"url":"\/38.2-3407.12\/"},{"id":69288,"section_number":"38.2-5201","catch_line":"What laws applicable","order_by":null,"url":"\/38.2-5201\/"}],"refers_to":[{"id":72064,"section_number":"54.1-3300","catch_line":"Definitions","order_by":null,"url":"\/54.1-3300\/"}],"permalink":{"id":215145,"object_type":"law","relational_id":87046,"identifier":"38.2-3408","token":"38.2\/34\/2\/38.2-3408","url":"\/38.2-3408\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3408\/","token":"38.2\/34\/2\/38.2-3408","dublin_core":{"Title":"Policy providing for reimbursement for services that may be performed by certain practitioners other than physicians","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3408","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> If an accident and sickness insurance<\/span> policy provides reimbursement for any service that may be legally performed by a person<\/span> licensed in this Commonwealth as a chiropractor, optometrist, optician, professional counselor, psychologist, clinical social worker, podiatrist, physical therapist, chiropodist, clinical nurse specialist, audiologist, speech pathologist, certified nurse midwife or other advanced practice registered nurse, licensed certified midwife, licensed midwife, marriage and family therapist, athletic trainer, or licensed acupuncturist, reimbursement under the policy shall not be denied because the service is rendered by the licensed practitioner, provided that, for services performed by an athletic trainer, such service is performed in an office setting. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> If an accident and sickness insurance<\/span> policy provides reimbursement for a service that may be legally performed by a licensed pharmacist, reimbursement under the policy shall not be denied because the service is rendered by the licensed pharmacist, provided that (i) the service is performed for an insured for a condition under the terms of a collaborative agreement, as defined in § 54.1-3300<\/a>, (ii) the service is for the administration of vaccines for immunization, or (iii) the service is provided in accordance with § 54.1-3303.1<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> The reimbursement for a service provided by a licensed certified midwife or licensed midwife shall be in the same amount as the reimbursement paid under the policy to a certified nurse midwife for performing such service in the area served, provided that the claim is submitted using (i) the diagnoses and procedure codes applicable to the service; (ii) such licensed certified midwife’s or licensed midwife’s name; (iii) the national provider identifier for the licensed certified midwife or licensed midwife providing the service; and (iv) if required by the insurer<\/span>, the facility in which the service is provided. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> No insurer<\/span> shall reduce the reimbursement paid to a certified nurse midwife in order<\/span> to comply with the provisions of this section. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> This section shall not apply to Medicaid, or any state<\/span> fund. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nPOLICY PROVIDING FOR REIMBURSEMENT FOR SERVICES THAT MAY BE PERFORMED BY CERTAIN\nPRACTITIONERS OTHER THAN PHYSICIANS (\u00a7 38.2-3408)\n\nA. If an accident and sickness insurance policy provides reimbursement for any\nservice that may be legally performed by a person licensed in this Commonwealth\nas a chiropractor, optometrist, optician, professional counselor, psychologist,\nclinical social worker, podiatrist, physical therapist, chiropodist, clinical\nnurse specialist, audiologist, speech pathologist, certified nurse midwife or\nother advanced practice registered nurse, licensed certified midwife, licensed\nmidwife, marriage and family therapist, athletic trainer, or licensed\nacupuncturist, reimbursement under the policy shall not be denied because the\nservice is rendered by the licensed practitioner, provided that, for services\nperformed by an athletic trainer, such service is performed in an office\nsetting.\n\nB. If an accident and sickness insurance policy provides reimbursement for a\nservice that may be legally performed by a licensed pharmacist, reimbursement\nunder the policy shall not be denied because the service is rendered by the\nlicensed pharmacist, provided that (i) the service is performed for an insured\nfor a condition under the terms of a collaborative agreement, as defined in\n§ 54.1-3300, (ii) the service is for the administration of vaccines for\nimmunization, or (iii) the service is provided in accordance with §\n54.1-3303.1.\n\nC. The reimbursement for a service provided by a licensed certified midwife or\nlicensed midwife shall be in the same amount as the reimbursement paid under the\npolicy to a certified nurse midwife for performing such service in the area\nserved, provided that the claim is submitted using (i) the diagnoses and\nprocedure codes applicable to the service; (ii) such licensed certified\nmidwife’s or licensed midwife’s name; (iii) the national provider\nidentifier for the licensed certified midwife or licensed midwife providing the\nservice; and (iv) if required by the insurer, the facility in which the service\nis provided.\n\nD. No insurer shall reduce the reimbursement paid to a certified nurse midwife\nin order to comply with the provisions of this section.\n\nE. This section shall not apply to Medicaid, or any state fund.\n\nHISTORY: 1968, c. 588, \u00a7 38.1-347.1; 1973, c. 428; 1979, c. 13; 1986, c. 562;\n1987, cc. 549, 551, 557; 1989, cc. 7, 201; 1997, c. 203; 1998, c. 146; 2001, cc.\n102, 475; 2019, cc. 332, 333; 2020, cc. 726, 731; 2022, cc. 440, 441; 2023, c.\n183; 2025, c. 695.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}