July 27, 2023

Apple Health (Medicaid) Provider Alert

Attention providers:

Note: The changes detailed in this provider alert were sent out to providers on June 29, 2023. This is the 60-day notice concerning these same changes.

What changed?

The Health Care Authority (HCA) created the frequently asked questions (FAQ) documents listed in this Provider Alert to help highlight HCA’s telemedicine policy during the COVID-19 pandemic. Now that the public health emergency (PHE) has ended, these documents are no longer necessary. HCA will sunset these documents effective October 1, 2023.

To assist in this transition, updated versions of these documents, effective July 1, 2023, have been loaded on HCA’s Provider billing guides and fee schedules, under Telehealth, with important information concerning which policies will end and which will be found in program-specific billing guides.

Which documents have been updated?

 1. Apple Health (Medicaid) FAQ for applied behavior analysis (ABA) providers during the COVID-19 pandemic

2. Apple Health (Medicaid) behavioral health policy and billing during the COVID-19 pandemic (FAQ).
Note: This document was replaced with a completely new version titled Apple Health (Medicaid) FAQ for behavioral health providers billing for services provided via telemedicine. Effective July 1, 2023, see this new FAQ for guidance related to the Service Encounter Reporting Instructions (SERI) Guide and the Mental Health Services Billing Guide.

3. Apple Health (Medicaid) FAQ for diabetes education providers during the COVID-19 pandemic

4. Apple Health (Medicaid) FAQ for family planning only (FPO) providers during the COVID-19 pandemic

5. Apple Health (Medicaid) FAQ for home health providers during the COVID-19 pandemic

6. Apple Health (Medicaid) FAQ for long-term care facilities and skilled nursing facilities during the COVID-19 pandemic

7. Apple Health (Medicaid) FAQ for physical, occupational, and speech therapy during the COVID-19 pandemic

From July 1, 2023, to September 30, 2023

These updated FAQ documents will remain on HCA’s Provider billing guides and fee schedules webpage, under Telehealth.

Effective October 1, 2023

• HCA will sunset the FAQ documents, except for the Apple Health (Medicaid) FAQ for behavioral health providers billing for services provided via telemedicine. This FAQ will remain on HCA’s Provider billing guides and fee schedules webpage, under Telehealth, to provide telemedicine guidance related to the Service Encounter Reporting Instructions (SERI) Guide and the Mental Health Services Billing Guide.
• Program-specific telemedicine/telehealth information will be in specific HCA billing guides located on HCA’s Provider billing guides and fee schedules
• The main agency telemedicine policy will be in HCA’s Telemedicine policy billing guide located on HCA’s Provider billing guides and fee schedules webpage, under Telehealth.
• The main agency COVID-19 clinical policy will be in HCA’s Clinical policy for COVID-19 billing guide located on HCA’s Provider billing guides and fee schedules webpage, under Telehealth.

Email HCA’s Apple Health clinical policy team for any questions related to HCA’s telemedicine policy.

Note: HCA will resend this notice 60 days from the effective date, 30 days from the effective date, and one final time just before the effective date.

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