Filing · f0530
Virginia Medicaid Fee-for-Service (Cardinal Care FFS)
Virginia DMAS · Medicaid FFS · VA · CY2025
In 2025 this plan received 724,465 standard prior authorization requests and denied 24.4% of them. The median for Medicaid FFS plans of comparable size is 7.4%.
Standard denial rate
24.4%
724,465 standard requests, 177,032 denied.
8.6% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 724,465 | 547,433 | 177,032 | 24.4% |
| Expedited | 11,501 | 8,465 | 3,036 | 26.4% |
| Extended review, approved | 17,194 | |||
Appeals of standard denials
| Appeals filed | 11,298 |
| Denials overturned | 969 |
| Overturn rate | 8.6% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 5.2 d | — |
| Expedited | 75.8 h | — |