Billing Guide Updates, effective 10/1/18 and IMC Changes for 1/1/2019

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Apple Health (Medicaid) Provider Alert

Quarterly billing guide updates, effective October 1, 2018
Effective October 1, 2018, the Health Care Authority (HCA) is publishing quarterly updates to most of the Washington Apple Health billing guides. Billing guides are located on HCA’s Provider billing guides and fee schedule web page. Check the web page often. HCA is loading the revised billing guides as soon as they are finalized for publishing.

Changes coming to Washington Apple Health, effective January 1, 2019
Effective January 1, 2019, Apple Health managed care plans will begin covering behavioral health services (mental health and substance use disorder treatment), along with the currently covered physical health services.  

To view a map and table of the integrated managed care plans available within each region, please see Changes coming to Washington Apple Health.  You may also refer to the agency’s Apple Health managed care webpage. 

Apple Health clients without managed care plans (e.g., dual-eligible Medicare-Medicaid clients) will still have behavioral health coverage through one of the new integrated managed care plans. However, their plan will cover behavioral health services only. 

Most clients will remain with the same health plan, except in regions where clients’ plans will no longer be available. HCA will auto-enroll these clients to one of the offered plans.  

Clients can change their plan at any time by: