Apple Health - New instructions for expedited prior authorization for transgender surgical consultations

HCA Apple Health

PROVIDER ALERT

The Health Care Authority (the agency) pays for consultations related to gender reassignment surgery and surgery-related genital electrolysis or genital laser hair removal for eligible Apple Health clients. The agency pays for these consultations through fee-for-service. To ensure payment, bill the agency directly for the consultative visit using expedited prior authorization (EPA) # 870001400.   

The agency will add this update to the July 2016 edition of the Physician-Related Services/HealthCare Professional Services Billing Guide.