Ambulance transports – enhanced rates for ground and air ambulance

Washington State Health Care Authority sent this bulletin at 04/22/2020 04:19 PM PDT

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Apple Health (Medicaid) Provider Alert

Attention Ambulance Transportation providers:

Enhanced rate available for COVID-19-related transports

UPDATED 4/22/2020-The agency is updating this notification sent on 4/17/2020 to include air ambulance providers as eligible to also receive enhanced rates for transports.

Retroactive to dates of service on and after February 29, 2020, ground and air ambulance providers are eligible to receive enhanced rates for transports related to COVID-19. Possible rate enhancements are available when transporting a suspected or confirmed case of COVID-19 or when performing interfacility transfers to clear beds for COVID-19 capacity. The enhanced rates will continue to be paid for COVID-19 related transports until the declared state of emergency is discontinued.

Billing

When billing for these transports, providers must include modifier CR on the claim and a note that the transport is a COVID-19 related transport.

For COVID-19 related transports that have already been billed to HCA prior to this notice and did not include the CR modifier, providers may rebill to receive the enhanced rate. If modifier CR was included, HCA will adjust these claims to receive the enhanced rate.

To access HCA’s current rates, go to the agency’s provider billing guides and fee schedules webpage.

See HCA’s Information about novel coronavirus (COVID-19) webpage for updated information regarding COVID-19.

If providers have any questions, contact hcaambulanceadmin@hca.wa.gov.

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 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care 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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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.