                                 CODE OF VIRGINIA

POLICY PROVIDING FOR REIMBURSEMENT FOR SERVICES THAT MAY BE PERFORMED BY CERTAIN
PRACTITIONERS OTHER THAN PHYSICIANS (§ 38.2-3408)

A. 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.

B. 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
&#xA7; 54.1-3300, (ii) the service is for the administration of vaccines for
immunization, or (iii) the service is provided in accordance with &#xA7;
54.1-3303.1.

C. 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&#8217;s or licensed midwife&#8217;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. No insurer shall reduce the reimbursement paid to a certified nurse midwife
in order to comply with the provisions of this section.

E. This section shall not apply to Medicaid, or any state fund.

HISTORY: 1968, c. 588, § 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.