[Virginia] Simplifying MSK care with the HOPCo Digital Clinic

By August 17, 2026: Billing and clinical teams must identify which MSK-related CPT codes (orthopedic evaluation/management codes, MSK imaging, interventional procedures) used in your Virginia practice are eligible for HOPCo Digital Clinic referral. Coordinate with providers to understand the referral process—determine whether MSK patients should be routed to HOPCo virtual evaluation first versus direct specialty referral. Update referral templates and encounter documentation to capture HOPCo Digital Clinic participation and value-based initiative enrollment status. Establish tracking for claims that flow through the HOPCo program versus traditional MSK specialty referrals to monitor for billing differences, denials, or bundling impacts. Contact your Anthem Virginia representative to confirm specific covered MSK conditions, patient eligibility criteria, and any authorization or documentation requirements for HOPCo referrals. Failure to align referral patterns may result in suboptimal reimbursement or missed incentive opportunities under value-based arrangements.