Use of HCPCS Code J8799 for Billing Midwife Nursing Services

HCA Apple Health

Dear Provider: 

Effective for claims with dates of service on and after January 1, 2016, Washington Apple Health (Medicaid), administered by the Health Care Authority (the agency), requires providers to use HCPCS code J8499 for Methylergonovine (Methergine) 0.2 mg tablets when billing for midwife nursing services. Providers also must indicate the national drug code (NDC) on claims.

The agency will update the Planned Home Births and Births in Birthing Centers Provider Guide and fee schedule to reflect this requirement.