A. For the purposes of this section, "bill" means any statement of charges, an invoice, or any other form prepared by a health care provider or its agent, or third-party agent, identifying the costs of health care services provided.
§ 8.01-413.01.Authenticity and reasonableness of medical bills; presumption.
Chapter 14. Evidence · Article 7. Medical Evidence · Last amended 2022 · Last verified July 16, 2026
In one sentenceIn personal injury, wrongful death, or motor-vehicle medical-payments cases, this section creates a rebuttable presumption that a medical bill is authentic and reasonable once the plaintiff, or a substitute if unable to testify, identifies the bill and describes the treatment and its connection to the injury, provided the opposing side got the records 30 days before trial.
Full Text of § 8.01-413.01
B. In any action for personal injuries, wrongful death, or for medical expense benefits payable under a motor vehicle insurance policy issued pursuant to § 38.2-124 or § 38.2-2201, the authenticity of bills for medical services provided and the reasonableness of the charges of the health care provider shall be rebuttably presumed upon identification by the plaintiff of the original bill or a duly authenticated copy and the plaintiff's testimony (i) identifying the health care provider, (ii) describing the services rendered, and (iii) stating that the services were rendered in connection with treatment for the injuries received in the event giving rise to the action. If the court finds the plaintiff is unable to provide such testimony, the plaintiff's guardian, agent under an advance directive, or agent under a power of attorney may identify the bill or an authenticated copy and provide testimony in lieu of the plaintiff. The presumption herein shall not apply unless the opposing party or his attorney has been furnished such medical records at least 30 days prior to the trial.
C. Where no medical bill is rendered or specific charge made by a health care provider to the insured, an insurer, or any other person, the usual and customary fee charged for the service rendered may be established by the testimony or the affidavit of an expert having knowledge of the usual and customary fees charged for the services rendered. If the fee is to be established by affidavit, the affidavit shall be submitted to the opposing party or his attorney at least 30 days prior to trial. The testimony or the affidavit is subject to rebuttal and may be admitted in the same manner as an original bill or authenticated copy described in subsection A.
Plain-English Summary
Proving up a medical bill the old-fashioned way — calling a records custodian from every provider to authenticate every invoice — can turn a personal injury trial into a parade of foundation witnesses. Section 8.01-413.01 offers a shortcut. In actions for personal injuries, wrongful death, or medical expense benefits under certain auto insurance policies, a plaintiff’s own identification of the bill or an authenticated copy, paired with testimony naming the provider, describing the services, and connecting them to the injury from the event at issue, triggers a rebuttable presumption that the bill is authentic and the charges reasonable.
The section anticipates that the plaintiff might not always be able to testify, because of the injuries at issue, for instance. In that case, a guardian, an agent under an advance directive, or an agent under a power of attorney can identify the bill and give the supporting testimony instead. Either way, the presumption only kicks in if the opposing party or their attorney received the medical records at least 30 days before trial, giving the defense a real chance to investigate and rebut before the presumption does its work.
The last piece covers a gap: what if no bill was ever rendered for the service? The section lets the usual and customary fee for that kind of service be established instead through the testimony, or a sworn affidavit, of someone with expert knowledge of prevailing fees, with the same 30-day advance disclosure requirement if the affidavit route is used, and the resulting evidence remains subject to rebuttal just like an authenticated original bill would be.
Frequently Asked Questions
How does a plaintiff establish that a medical bill is authentic without calling the billing office as a witness?
By identifying the original bill or a duly authenticated copy and testifying to the health care provider’s identity, the services rendered, and that the services were provided in connection with the injuries from the event giving rise to the action, which creates a rebuttable presumption of authenticity and reasonableness.
What if the plaintiff cannot testify because of their injuries?
If the court finds the plaintiff unable to provide such testimony, the plaintiff’s guardian, agent under an advance directive, or agent under a power of attorney may identify the bill and provide the testimony instead.
Is there a deadline for turning over medical records for this presumption to apply?
Yes, the presumption does not apply unless the opposing party or their attorney has been furnished the medical records at least 30 days prior to trial.
What happens if no bill was ever issued for a particular medical service?
The usual and customary fee for that service may be established by the testimony or affidavit of an expert with knowledge of the usual and customary fees for such services, with the affidavit submitted to the opposing party at least 30 days before trial.
Can the defense challenge a medical bill even after this presumption applies?
Yes, the presumption is rebuttable, and the testimony or affidavit establishing a usual and customary fee is likewise subject to rebuttal.
Amendment History
1993, c. 610; 1996, c. 516; 1997, c. 503; 2016, c. 243; 2022, cc. 469, 470.
Source & verification. Section text and amendment history are
reproduced verbatim from the Code of Virginia, published by the
Code of Virginia, Virginia Division of Legislative Automated Systems. Last verified July 16, 2026.
· Official source
Also known as: virginia medical bill presumption statuteva code 8.01-413.01proving medical bills at trial virginiareasonableness of medical charges virginia personal injuryusual and customary fee affidavit virginia