Substance Use Disorder Program Billing Guide, effective 8/1/19

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Apple Health (Medicaid) Provider Alert

Attention Fee-for-service Substance Abuse Disorder Providers:

The Health Care Authority (HCA) has published a revised Substance Use Disorder Program Billing Guide, effective August 1, 2019.

What has changed?

  • Added a new integrated managed care region, effective July 1, 2019, called North Sound. North Sound region includes Island, San Juan, Skagit, Snohomish, and Whatcom counties.

  • Added procedure code H0038 SUD peer services to the outpatient and residential SUD tables.

  • Added a new section for coverage and payment of peer support services.

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