PROVIDERS: Health Care Authority coverage for telehealth services

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Health Care Authority (HCA) coverage for telehealth services

HCA reimburses providers for telemedicine services as related to RCW 74.09.325

Telehealth/telemedicine services provide an important and rapidly evolving suite of access tools for providers and patients for medical, dental and behavioral health services. The Washington Department of Health (DOH) and the Centers for Disease Control (CDC) are referencing the potential use of these tools as part of the state and national response required by the current coronavirus situation.

This document provides information about how to find policies and guidance for billing for telehealth services. It does not provide advice on how to deliver or receive health care or provide medical advice.

An example of a covered telemedicine service includes:

A client/patient calls a provider’s office to request an appointment due to respiratory symptoms and a fever. Instead of making an initial in-person appointment, the provider’s office could set up an appointment with the provider via telemedicine with the client at home. This is an eligible service and the provider could bill for reimbursement of the services.

Apple Health (Medicaid) clients

For Apple Health clients the provider would need to check client eligibility in ProviderOne to see which type of insurance coverage the client is eligible to receive. Instructions on navigating ProviderOne is in the ProviderOne Billing and Resource Guide on page 20.

Apple Health Program

Link to Policy/Payment

Customer service #

Fee For Service

Physician-Related Service/Health Care Professional Services Billing Guide


Managed Care Organizations

Link to Policy/Payment

Customer service #


Molina Provider Guide



Telemedicine Policy



Telemedicine FAQ


Community Health Plan of WA

Telehealth Services


Coordinated Care of WA

Covered Services Grid


***This information is also available as a PDF