Revised policies for COVID-19 for billing POS 10

Washington State Health Care Authority sent this bulletin at 07/06/2022 12:01 PM PDT

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Apple Health (Medicaid) Provider Alert

What changed?

Effective for dates of service on and after July 22, 2022, when billing for place of service (POS) 10, add modifier 95 to the claim if the distant site is designated as a nonfacility. This will ensure that the nonfacility provider will receive the nonfacility payment.

The Health Care Authority (HCA) is updating the following documents with this billing guidance:

Apple Health (Medicaid) Applied Behavior Analysis (ABA) policy and billing during the COVID-19 pandemic
Apple Health (Medicaid) clinical policy and billing for COVID-19 (includes telemedicine/telehealth)
Apple Health (Medicaid) frequently asked questions (FAQ) for diabetes education providers in the COVID-19 pandemic
Apple Health (Medicaid) telehealth requirements for physical, occupational, and speech therapy during the COVID-19 pandemic

These documents are available on HCA’s Provider billing guides and fee schedules webpage, under Telehealth.

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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Nondiscrimination

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.

Revised policies for COVID-19 for billing POS 10

Apple Health (Medicaid) Provider Alert

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About the Health Care Authority (HCA)

Disclosure notice

Nondiscrimination