Medical Equipment & Supplies Billing Guide Update, 8/1/2019

Washington State Health Care Authority sent this bulletin at 07/26/2019 09:39 AM PDT

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Apple Health (Medicaid) Provider Alert

Attention Medical Equipment and Supplies Providers:

The Health Care Authority (HCA) revised the Medical Equipment and Supplies Billing Guide, published July 2019.

What has changed?

HCA fixed the following errors in the July 2019 published billing guide:

Place of service 14 (group home) was missing from the list for billing and is added back to the list under billing claims electronically.
Retroactive to dates of service on and after April 1, 2019, prior authorization (PA) is required for procedure codes E0163, E0167 and E0168.

For specific details on these changes, see the What is Changed table inside the updated guide, dated August 1, 2019. The updated guide is available on HCA’s Provider billing guides and fee schedules webpage.

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.