Revised policy for therapies for COVID-19

Having trouble viewing this email? View it as a Web page.

Health Care Authority (HCA) logo

Apple Health (Medicaid) Provider Alert

Attention providers

What changed? 
The Health Care Authority (HCA) has made the following updates to its COVID-19 therapies policy with information regarding COVID-19 monoclonal antibodies:

Procedure codes no longer covered by HCA
Retroactive for dates of service on and after January 24, 2022, HCA no longer covers the following procedure codes due to the Food and Drug Administration (FDA) revoking their emergency use authorization (EUA):

* M0240
* M0241
* M0243
* M0244
* M0245
* M0246
* Q0240
* Q0243
* Q0244
* Q0245

Retroactive for dates of service on and after April 5, 2022, HCA no longer covers the following procedure codes due to the FDA revoking their EUA:

* M0247
* M0248
* Q0247

See Therapies for COVID-19, under COVID-19 resources, Testing and Treatment for more information regarding the policy and procedure codes involved.

COVID-19 Fee Schedule
HCA revised the COVID-19 Fee Schedule. See HCA’s Provider billing guides and fee schedules, under COVID-19.