Apple Health – How you bill for ambulance services is changing January 1, 2018

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Apple Health (Medicaid) Provider Alert

What is changing?

Effective for dates of service on and after January 1, 2018, all emergency and nonemergency ambulance services provided to Apple Health clients will be covered under fee-for-service. This includes ambulance services for clients enrolled in an agency-contracted managed care organization (MCO).  

Who do I bill for ambulance services? 

  • For claims with dates of services on and after January 1, 2018, providers must bill these claims directly to the agency through the ProviderOne payment system. Do not bill the MCO. 

  • For claims with dates of service before January 1, 2018, providers must bill the appropriate MCO. 

This information will be reflected in the January 1, 2018, publication of the Ambulance and Involuntary Treatment Act (ITA) Transportation Billing Guide. 

Please direct questions or concerns to Chris Hughes, Ambulance and ITA Program Manager, at christopher.hughes@hca.wa.gov.