Apple Health: Outpatient Hospital Billing Guide - Correction

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Apple Health (Medicaid) Provider Alert

On March 15, 2017, The Health Care Authority (Medicaid) notified providers of an error in the July 1, 2015, Outpatient Hospital Services Provider Guide regarding EPA #870001370 (services rendered in the ER to an MCO client).  

EPA #870001370 was discontinued for dates of service on and after January 1, 2015, and should not have been listed in this guide or in the following guides.  

  • October 1, 2015 – December 31, 2015
  • January 1, 2016 – March 31, 2016
  • April 1, 2016 – September 30, 2016

Providers should refer to the current Outpatient Hospital Services Billing Guide for instructions on billing for emergency room visits for an MCO client that occurred on or after January 1, 2015.