Physician-related Services/Health Care Services Billing Guide updates

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Apple Health (Medicaid) Provider Alert

The Health Care Authority (HCA) updated the Physician-Related Services/Health Care Services Billing Guide, effective March 1, 2018.

What has changed?

  • Added wording that medical visits using Store and Forward telemedicine technology can be provided via “asynchronous” telemedicine. The January 1, 2018 version of the guide incorrectly stated “synchronous.”
  • Added information about the professionally administered drug Makena, including authorization information and new CPT code J1726 which replaces CPT code J1725.
  • Listed professionally administered drugs that are reimbursed through fee-for-service for managed care clients.

Additional changes are noted on page 3 of the guide.