Virginia Environmental Modification Policy Manual
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The Virginia ADM-1.0 Administration Policy establishes the framework for compliance with 12VAC30-122-370, which governs documentation standards for environmental modifications (EM) services under Virginia’s Medicaid waiver programs. This policy ensures that providers deliver medically necessary physical adaptations to an individual’s primary residence or vehicle to enhance health, safety, and independence while adhering to state and federal regulations. Environmental modifications are covered under the Family and Individual Supports (FIS), Community Living (CL), and Building Independence (BI) waivers.
Providers must maintain comprehensive documentation for all EM services, including service authorizations, justification of medical necessity, progress notes, installation records, and verification of completion. Documentation must demonstrate that the modification aligns with the individual’s plan for supports and complies with applicable building codes and safety standards. Providers are required to ensure that modifications are completed in the least expensive manner possible within the annual funding limit of $5,000 per individual. Exclusions include general home improvements, aesthetic changes, and modifications that add square footage to a home or vehicle.
This policy emphasizes accurate record-keeping to support claims for reimbursement, facilitate audits, and ensure compliance with Medicaid requirements. By adhering to 12VAC30-122-370, providers can deliver high-quality environmental modification services that promote accessibility and independence for individuals enrolled in Virginia’s Medicaid waiver programs.