Apple Health (Medicaid) Provider Alert
Currently, ambulance providers use the expedited prior
authorization (EPA) process for nonemergency ambulance transportation services
under certain circumstances or conditions (EPA# 870001404).
Effective
for dates of service on and after April 1, 2018,
the Health Care Authority expanded the list of circumstances and conditions
under which an ambulance provider may use EPA# 870001404. The list now includes:
- Hospital
to hospital transfer (i.e. services are not available at sending facility, or
there are no beds available at sending facility, and the client requires
admission and the ambulance transportation is medically necessary)
- Intravenous
(IV) infusion monitoring
This update, along with the complete list of when it
is appropriate to use EPA# 870001404, is located in the April 1 publication of
the Ambulance
and ITA Transportation Billing Guide.
For more information, contact Abigail Cole at abigail.cole@hca.wa.gov.
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