Physician-related Services/Health Care Services Billing Guide updates

Washington State Health Care Authority sent this bulletin at 02/28/2018 02:57 PM PST

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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.

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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