Billing reminder for incontinence supplies

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Apple Health (Medicaid) Provider Alert

Attention Medical equipment and supplies providers:

The Health Care Authority (HCA) is providing a reminder for billing of incontinence supplies. When billing HCA for incontinence products, your claim must be for a single date of service with at least 30 days in between claims.

For example, a date of service (DOS) for the month of May would be 5/15/19-5/15/19 on the first claim. The next claim would be for June dates of service, 6/14/19-6/14/19, 30 days in between dates of service.

  • May claim: 5/15/2019-5/15/2019, 200 units
  • June claim: 6/14/2019-6/14/2019, 200 units

If the billing is for a limit that is over the allowed amount and HCA has authorized a limitation extension, bill on two separate lines—one claim line for the allowed amount and one claim line for the exceeded limit. The claim line with additional authorized limit must include the authorization number.

  • May claim line 1: 5/15/2019-5/15/2019, 200 units
  • May claim line 2: 5/15/2019-5/15/2019, 100 units, authorization #
  • June claim line 1: 6/14/2019-6/14/2019, 200 units
  • June claim line 2: 6/14/2019-6/14/2019, 100 units, authorization #

This information can also be found in the Medical equipment and supplies billing guide.