16VAC30-110-10: Definitions

The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Commission" means the Virginia Workers' Compensation Commission.

"Community" means one of the six medical communities as defined in § 65.2-605 of the Code of Virginia.

"Ground rules"

1. For medical services rendered during the period from January 1, 2018, through December 31, 2019, means the 2018 Medical Fee Schedule Ground Rules adopted by the commission on June 13, 2017, and revised on July 18, 2019, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/documents/2018-mfs-ground-rules.

2. For medical services rendered during the period from January 1, 2020, through December 31, 2021, means the 2020 Medical Fee Schedule Ground Rules adopted by the commission on July 18, 2019, and revised on October 17, 2019, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/documents/2020-medical-fee-schedules-ground-rules.

3. For medical services rendered during the period from January 1, 2022, through December 31, 2023, means the 2022 Medical Fee Schedule Ground Rules adopted by the commission on June 29, 2021, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/documents/2022-medical-fee-schedules-ground-rules.

4. For medical services rendered during the period from January 1, 2024, through December 31, 2025, means the 2024 Medical Fee Schedule Ground Rules adopted by the commission on August 17, 2023, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/medical-fee-services/2024-medical-fee-schedules-ground-rules.

5. For medical services rendered during the period from January 1, 2026, through December 31, 2028, means the 2026 Medical Fee Schedule Ground Rules adopted by the commission on June 17, 2025, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/medical-fee-services/2026-medical-fee-schedules-ground-rules.

"Medical services" means any medical, surgical, or hospital service required to be provided to an injured person pursuant to Title 65.2 of the Code of Virginia, exclusive of a medical service provided in the treatment of a traumatic injury or serious burn as those terms are defined in § 65.2-605 A of the Code of Virginia.

"Virginia fee schedules"

1. For medical services rendered during the period from January 1, 2018, through December 31, 2019, means the 2018 Medical Fee Schedules adopted by the commission on June 13, 2017, and revised on November 14, 2017, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/content/2018-medical-fee-schedule.

2. For medical services rendered during the period from January 1, 2020, through December 31, 2021, means the 2020 Medical Fee Schedules adopted by the commission on July 18, 2019, and revised on October 17, 2019, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/content/2020-virginia-medical-fee-schedules.

3. For medical services rendered during the period from January 1, 2022, through December 31, 2023, means the 2022 Medical Fee Schedules adopted by the commission on June 29, 2021, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/content/2022-virginia-medical-fee-schedules.

4. For medical services rendered during the period from January 1, 2024, through December 31, 2025, means the 2024 Medical Fee Schedules adopted by the commission on August 17, 2023, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/medical-fee-services/2024-medical-fee-schedules.

5. For medical services rendered during the period from January 1, 2026, through December 31, 2027, means the 2026 Medical Fee Schedules adopted by the commission on June 17, 2025, incorporated by reference in this chapter and available on the commission's website at https://www.workcomp.virginia.gov/medical-fee-services/2026-medical-fee-schedules.