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Attention providers:
What is changing?
Effective for dates of service on and after October 1, 2024, the Health Care Authority (HCA) no longer requires the Compression Garments form (HCA 13-871) to accompany prior authorization (PA) requests for compression garments.
What is still required?
Medical record documentation, sourced from the client’s Electronic Health Record (EHR), must be included in the PA request, as outlined in WAC 182-501-0165, as credible evidence to substantiate guidelines for medical necessity as specified in the billing guide.
Billing Guide and Fee Schedule
HCA revised the Medical Equipment & Supplies Billing Guide to reflect this change. See HCA’s Provider billing guides and fee schedules, under Medical Equipment & Supplies, published January 1, 2025.
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