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ProviderOne Newsletter:
DSHS Social Services Providers
January 2026
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Rate changes effective January 1, 2026
To reflect the 2026 annual update to the Income & Resource Standards for client participation, daily rates for Assisted Living Facilities changed effective January 1, 2026. For more information, please refer to MB 25-066: January 1, 2026, Home and Community Services and Developmental Disabilities Community Services Rates. Providers can view the updated rates on the Office of Rates Management website.
Providers should review their ProviderOne Authorization List to confirm any impacted rates have been updated as needed and contact the client's authorizing case manager if the rate has not been updated. Providers should not submit claims for services delivered in January until the rate has been updated on the authorization.
For step-by-step directions on how to view the ProviderOne Authorization List and the associated rates, see the Getting Started and Billing Essentials Guide.
Updated billing guides
The ProviderOne for Social Services Billing Guides have been updated effective January 1, 2026. Click here for more information.
Reminder: The purpose of the billing guides is to provide directions on how to view the ProviderOne authorization list, how to submit claims, how to view payments, etc. For questions related to what is billable, when to add an additional non-authorized modifier to a claim, how many units to bill for a service provided, etc., providers should refer to their DSHS/AAA Contract or reach out to their Contract Specialist.
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Billing for social services medical codes
When submitting claims for Social Services Medical services (i.e., private duty nursing, nurse delegation, behavioral health services, etc.), providers are responsible for
calculating the submitted charges (also known as the billed amount). The 'submitted charge' is equal to the authorized rate times the number of units served. Directions on how to calculate the billed amount can be found on page 16 in the Submitting and Adjusting Social Services Medical Claims Guide.
If you are a Social Services (Non-Medical) Provider, this message does not apply to you. Social Services Non-Medical Providers do not need to calculate the billed amount when submitting non-medical claims. ProviderOne automatically calculates the billed amount for non-medical service codes based on the authorized rate and number of units billed.
Monthly FAQ: When will I receive my 2025 tax forms?
1099 tax forms for 2025 are sent via U.S. Mail and will be mailed by January 31, 2026. If you are a Social Services Provider who receives payment through ProviderOne and have not received your 1099 tax form by mid-February, please email the appropriate contact:
- DSHS Social Services Adult Family Homes (AFHs), contact 1099reporting@hca.wa.gov
- DSHS Social Services Providers (other than AFHs), contact taxinfo@dshs.wa.gov
When emailing, please provide your name, the name of your business as listed on your tax return, your tax ID/ EIN or your Provider One ID, and a brief description of what you need assistance with.
- Individual providers/caregivers employed by Consumer Direct Washington (CDWA) or a Home Care Agency, contact your employer for questions about tax forms.
Resource spotlight
New provider corner
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About the newsletter
The ProviderOne for DSHS Social Services Providers Newsletter is published monthly by the Department of Social & Health Services (DSHS) in collaboration with the Health Care Authority (HCA). The intent of the newsletter is to share ProviderOne information, updates, and resources for DSHS-contracted providers who submit authorized claims through the ProviderOne system.
Visit the ProviderOne for Social Services webpage to view past newsletters and to read more about ProviderOne for Social Services.
Sign up to receive the monthly newsletter and other ProviderOne for Social Services notifications.
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