Medallion 4.0

Overview

Medallion 4.0 is Virginia’s Medicaid program for infants, children, pregnant women and adults in low-income families with children.  Medallion 4.0 provides acute and primary healthcare services, prescription drug coverage and behavioral health services. View a one-page overview of the program.

Note: DMAS plans to discontinue use of the Medallion 4.0 managed care program name.

Community Mental Health Rehabilitation Services

The Community Mental Health Rehabilitation Services (CMHRS) and Behavioral Therapy transition to Medallion 4.0 will occur in accordance with the regional implementation of the program, beginning August 1, 2018. On each effective date, Magellan of Virginia, DMAS’s Behavioral Health Services Administrator (BHSA) will no longer administer CMHRS and Behavioral Therapy for Medallion 4.0 enrolled members. Instead, CMHRS and Behavioral Therapy will transition into the Medallion 4.0 MCO contract, utilizing DMAS’ current CMHRS coverage criteria and program requirements. Using the Integrated Care Model, this benefit will impact over 750,000 Medicaid members, including children enrolled in Medallion 4.0 and Family Access to Medical Insurance Security (FAMIS) Plan. CMHRS providers will follow the CCC Plus authorization processes for Medallion 4.0. Providers will use the same CCC Plus authorization/registration forms found on the DMAS website. Questions regarding the CMHRS transition into Medallion 4.0 can be e-mailed to M4.0-CMHRS@dmas.virginia.gov. For more information and service authorization forms, please visit The CMHRS Webpage.

Medallion 4.0 Focus

Timelines