Physician-related services billing guide update

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Apple Health (Medicaid) Provider Alert

Retroactive to dates of services on and after January 1, 2019, the Health Care Authority (the agency) published an updated Physician-related services billing guide. The updated guide is available on the agency’s Provider billing guides webpage.

What has changed?

The agency discontinued and replaced the following CPT® codes for magnetic resonance imaging (MRI) but did not include these changes in the initial January 1, 2019, publication of the guide. These are now included:

  • Discontinued 77058 and replaced with 77046 and 77048
  • Discontinued 77059 and replaced with 77047 and 77049

On page 187 of the January 1, 2019, publication of the guide, under continuous glucose monitoring, information for CGM greater than 72 hours is not effective until February 1, 2019. The agency added this effective date.