Apple Health (Medicaid): Provider Alert

Effective for dates of service on and after June 1, 2017, Washington Apple Health (Medicaid), administered by the Health Care Authority, will implement two expedited authorization codes to allow quicker access to smoking (tobacco) cessation treatment.

EA code 072 allows pharmacies to self-report that a client is receiving tobacco cessation counseling through the Washington State Tobacco Quitline.  The client must present a valid prescription for a prescription smoking (tobacco) cessation product. 

EA code 073 allows pharmacies to self-report that a client is pregnant and receiving counseling from the prescriber or other qualified practitioner.  A client who is pregnant is not required to be enrolled in the Quitline. However, the client must have face-to-face counseling for smoking (tobacco) cessation with the provider and have a valid prescription for the medication or over-the-counter product.  The provider must write on the prescription that the prescriber/qualified practitioner is providing counseling.  A client who is pregnant can enroll in the Quitline if the client is not receiving counseling from a prescriber.

For more information on Medicaid’s smoking cessation program, see the Physician-Related Services/Health Care Professional Services Billing Guide.

See also the Expedited Authorization (EA) list. 

Please do not reply directly to this message. If you have feedback or questions, please visit the HCA website for contact information.

About Washington State Health Care Authority
HCA oversees the state’s top two health care purchasers — Washington Apple Health (Medicaid) and the Public Employee Benefits Board Program. We work with partners to help ensure Washingtonians have access to better health and better care at a lower cost. For more information, visit www.hca.wa.gov.