Apple Health: Outpatient Hospital Billing Guide - Correction

Washington State Health Care Authority sent this bulletin at 07/17/2017 02:55 PM PDT

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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.

About the Health Care Authority (HCA)

The Washington State Health Care Authority purchases health care for more than 2 million Washington residents through Apple Health (Medicaid) and the Public Employees Benefits Board (PEBB) Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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