Apple Health Billing Guide Updates, Effective 1/1/20

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Apple Health (Medicaid) Provider Alert

Apple Health Billing Guide Updates – Effective January 2020

Effective January 1, 2020, the Health Care Authority (HCA) is publishing quarterly updates to most of the Apple Health billing guides. Billing guides are located on HCA’s Provider billing guides and fee schedules webpage. Check the webpage often. HCA is loading the revised billing guides as soon as they are finalized for publishing. 

Integrated managed care – Effective January 2020 

Effective January 1, 2020, HCA completes the move to whole person care to allow better coordination of care for both body (physical health) and mind (mental health and substance use disorder treatment, together known as “behavioral health”). This delivery model is called Integrated Managed Care (IMC).

Integrated managed care is being implemented in the last three regions of the state: Great Rivers (Cowlitz, Grays Harbor, Lewis, Pacific, and Wahkiakum counties), Salish (Clallam, Jefferson, and Kitsap counties), and Thurston-Mason (Mason and Thurston) counties.

See HCA’s Apple Health managed care webpage for details and the Changes coming to Washington Apple Health map and table, (HCA 19-0025).