Billing for enteral nutrition with overlap in dates of service

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Apple Health (Medicaid) Provider Alert

The Health Care Authority (HCA) made updates to the Enteral nutrition – Provider requirements WAC 182-554-400. A new section was added to clarify that HCA allows up to a 10-day overlap in dates of service for the processing of claims for refills delivered/shipped prior to the client exhausting their supply.

This billing process is effective for claims with dates of service on and after September 1, 2022.

This update will be reflected in HCA’s Enteral Nutrition Billing Guide effective September 1, 2022.