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VA Fee Schedule–2023
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Effective February 1, 2023
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Rates in this schedule will be used by VA, TriWest and Optum
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RowProcedureModifierLocality descriptionMedicare localityMedicare carrierWas Care Rendered in a Facility?
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 Yes No
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10042T
SAN FRANCISCO-OAKLAND-HAYWARD (SAN FRANCISCO CNTY)
0501112 $ 265.80 $ 265.80
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20042T SAN FRANCISCO-OAKLAND-HAYWARD (SAN MATEO CNTY) 0601112 $ 265.80 $ 265.80
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30042T
SAN FRANCISCO-OAKLAND-HAYWARD (ALAMEDA/CONTRA COSTA CNTY)
0701112 $ 265.80 $ 265.80
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40042T
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY)
0901112 $ 269.14 $ 269.14
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50042T NAPA 5101112 $ 259.24 $ 259.24
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60042T SAN FRANCISCO-OAKLAND-HAYWARD (MARIN CNTY) 5201112 $ 264.87 $ 264.87
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70042T VALLEJO-FAIRFIELD 5301112 $ 259.24 $ 259.24
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80042T BAKERSFIELD 5401112 $ 228.41 $ 228.41
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90042T CHICO 5501112 $ 227.58 $ 227.58
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100042T FRESNO 5601112 $ 227.58 $ 227.58
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110042T HANFORD-CORCORAN 5701112 $ 227.58 $ 227.58
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120042T MADERA 5801112 $ 227.58 $ 227.58
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130042T MERCED 5901112 $ 227.58 $ 227.58
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140042T MODESTO 6001112 $ 227.58 $ 227.58
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150042T REDDING 6101112 $ 227.58 $ 227.58
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160042T RIVERSIDE-SAN BERNARDINO-ONTARIO 6201112 $ 228.94 $ 228.94
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170042T SACRAMENTO--ROSEVILLE--ARDEN-ARCADE 6301112 $ 228.62 $ 228.62
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180042T SALINAS 6401112 $ 255.80 $ 255.80
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190042T SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) 6501112 $ 266.95 $ 266.95
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200042T SANTA CRUZ-WATSONVILLE 6601112 $ 257.78 $ 257.78
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210042T SANTA ROSA 6701112 $ 256.64 $ 256.64
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220042T STOCKTON-LODI 6801112 $ 227.58 $ 227.58
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230042T VISALIA-PORTERVILLE 6901112 $ 227.58 $ 227.58
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240042T YUBA CITY 7001112 $ 227.58 $ 227.58
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250042T REST OF CALIFORNIA 7501112 $ 227.58 $ 227.58
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260042T OXNARD-THOUSAND OAKS-VENTURA 1701182 $ 257.37 $ 257.37
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270042T LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES CNTY) 1801182 $ 258.41 $ 258.41
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280042T LOS ANGELES-LONG BEACH-ANAHEIM (ORANGE CNTY) 2601182 $ 258.41 $ 258.41
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290042T EL CENTRO 7101182 $ 227.69 $ 227.69
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300042T SAN DIEGO-CARLSBAD 7201182 $ 255.70 $ 255.70
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310042T SAN LUIS OBISPO-PASO ROBLES-ARROYO GRANDE 7301182 $ 228.52 $ 228.52
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320042T SANTA MARIA-SANTA BARBARA 7401182 $ 256.43 $ 256.43
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330042T HAWAII/GUAM 0101212 $ 254.55 $ 254.55
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340042T NEVADA 0001312 $ 226.75 $ 226.75
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350042T IDAHO 0002202 $ 208.35 $ 208.35
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360042T PORTLAND 0102302 $ 226.96 $ 226.96
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370042T REST OF OREGON 9902302 $ 213.87 $ 213.87
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380042T SEATTLE (KING CNTY) 0202402 $ 258.82 $ 258.82
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390042T REST OF WASHINGTON 9902402 $ 224.35 $ 224.35
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400042T ARIZONA 0003102 $ 221.02 $ 221.02
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410042T MONTANA 0103202 $ 222.06 $ 222.06
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420042T NORTH DAKOTA 0103302 $ 220.71 $ 220.71
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430042T SOUTH DAKOTA 0203402 $ 213.67 $ 213.67
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440042T UTAH 0903502 $ 212.94 $ 212.94
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450042T WYOMING 2103602 $ 222.58 $ 222.58
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460042T COLORADO 0104112 $ 226.02 $ 226.02
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470042T NEW MEXICO 0504212 $ 213.98 $ 213.98
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480042T OKLAHOMA 0004312 $ 210.44 $ 210.44
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490042T BRAZORIA 0904412 $ 225.60 $ 225.60
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500042T DALLAS 1104412 $ 225.29 $ 225.29
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510042T GALVESTON 1504412 $ 225.81 $ 225.81
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520042T HOUSTON 1804412 $ 227.48 $ 227.48
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530042T BEAUMONT 2004412 $ 213.98 $ 213.98
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540042T FORT WORTH 2804412 $ 223.41 $ 223.41
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550042T AUSTIN 3104412 $ 225.60 $ 225.60
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560042T REST OF TEXAS 9904412 $ 214.81 $ 214.81
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570042T IOWA 0005102 $ 210.64 $ 210.64
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580042T KANSAS 0005202 $ 210.54 $ 210.54
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590042T METROPOLITAN ST. LOUIS 0105302 $ 222.68 $ 222.68
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600042T METROPOLITAN KANSAS CITY 0205302 $ 221.33 $ 221.33
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610042T REST OF MISSOURI 9905302 $ 209.08 $ 209.08
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620042T NEBRASKA 0005402 $ 209.92 $ 209.92
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630042T EAST ST. LOUIS 1206102 $ 224.35 $ 224.35
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640042T SUBURBAN CHICAGO 1506102 $ 254.34 $ 254.34
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650042T CHICAGO 1606102 $ 255.28 $ 255.28
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660042T REST OF ILLINOIS 9906102 $ 214.60 $ 214.60
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670042T MINNESOTA 0006202 $ 222.58 $ 222.58
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680042T WISCONSIN 0006302 $ 212.21 $ 212.21
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690042T ARKANSAS 1307102 $ 207.10 $ 207.10
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700042T NEW ORLEANS 0107202 $ 222.58 $ 222.58
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710042T REST OF LOUISIANA 9907202 $ 212.62 $ 212.62
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720042T MISSISSIPPI 0007302 $ 208.04 $ 208.04
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730042T INDIANA 0008102 $ 210.23 $ 210.23
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740042T DETROIT 0108202 $ 226.96 $ 226.96
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750042T REST OF MICHIGAN 9908202 $ 213.46 $ 213.46
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760042T FORT LAUDERDALE 0309102 $ 227.69 $ 227.69
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770042T MIAMI 0409102 $ 256.32 $ 256.32
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780042T REST OF FLORIDA 9909102 $ 222.37 $ 222.37
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790042T PUERTO RICO 2009202 $ 225.08 $ 225.08
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800042T VIRGIN ISLANDS 5009202 $ 225.08 $ 225.08
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810042T ALABAMA 0010112 $ 212.00 $ 212.00
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820042T ATLANTA 0110212 $ 224.35 $ 224.35
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830042T REST OF GEORGIA 9910212 $ 211.79 $ 211.79
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840042T TENNESSEE 3510312 $ 210.44 $ 210.44
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850042T SOUTH CAROLINA 0111202 $ 211.69 $ 211.69
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860042T VIRGINIA 0011302 $ 224.14 $ 224.14
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870042T WEST VIRGINIA 1611402 $ 211.37 $ 211.37
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880042T NORTH CAROLINA 0011502 $ 213.77 $ 213.77
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890042T DELAWARE 0112102 $ 225.81 $ 225.81
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900042T DC + MD/VA SUBURBS 0112202 $ 264.03 $ 264.03
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910042T BALTIMORE/SURR. CNTYS 0112302 $ 256.22 $ 256.22
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920042T REST OF MARYLAND 9912302 $ 227.48 $ 227.48
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930042T NORTHERN NJ 0112402 $ 260.60 $ 260.60
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940042T REST OF NEW JERSEY 9912402 $ 257.16 $ 257.16
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950042T METROPOLITAN PHILADELPHIA 0112502 $ 254.76 $ 254.76