Home Infusion Therapy and Parenteral Nutrition Billing Guide updates, eff. 2/1/19

Washington State Health Care Authority sent this bulletin at 01/30/2019 02:09 PM PST

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Apple Health (Medicaid) Provider Alert

The Health Care Authority (HCA) revised the Home Infusion Therapy and Parenteral Nutrition Billing Guide, effective February 1, 2019.

What has changed?

The agency updated the following information in this guide:

Added information for requesting prior authorization online
Added requirement for a written order from a physician for all equipment and supplies
Added new section for continuous glucose monitoring (CGM), including new expedited prior authorization requirements (EPA)
Changed limits for HCPCs code A4221 to four units = one month

For specific details on these changes, see the “What has changed” table inside the updated guide. The updated billing guide is located on HCA’s Provider billing guides and fee schedules web page.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than two million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, and, beginning in 2020, the School Employees Benefits Board (SEBB) 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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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.

Home Infusion Therapy and Parenteral Nutrition Billing Guide updates, eff. 2/1/19

Apple Health (Medicaid) Provider Alert

Thank you for subscribing to Provider Alerts

About the Health Care Authority (HCA)

Disclosure notice

Nondiscrimination