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Attention providers:
What changed?
Effective for dates of service on and after July 1, 2023, the Health Care Authority (HCA) expanded the eligibility criteria for medical respite care (MRC) to include clients who are referred from a medical clinic.
Clients who are experiencing homelessness and have medical and behavioral health issues, and who either have been recently discharged from a hospital setting OR referred from a medical clinic (e.g., primary care clinic, federally qualified health center, urgent care facility, mobile medical clinic, etc.) may receive medical respite care. Both of the following must also be true:
- Client has an acute medical condition that can be safely managed in a shelter outpatient setting
- Medical respite care is necessary to provide the conditions to support recovery from the acute medical condition
Billing Guide and Fee Schedule
HCA revised the Physician-Related Services/Health Care Professional Services Billing Guide, dated July 1, 2023, to reflect this change. See HCA’s Provider billing guides and fee schedules, under Physician-related/professional services.
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