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

HCA Apple Health


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.