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Attention providers:
Effective for dates of service on and after April 1, 2025, the Health Care Authority (HCA) added an updated COVID-19 molecular and antigen testing section to HCA’s Physician-Related Services/Health Care Professional Services Billing Guide unrelated to over-the-counter COVID-19 testing. This update includes new medical necessity criteria and fee-for-service billing instructions. HCA is making these changes to align with evidence-based practices
HCA is releasing this new policy early to assist providers during the transition of these policies.
The current policy remains in effect through dates of service March 31, 2025.
HCA revised the Physician-Related Services/Health Care Professional Services Billing Guide with these changes, and the revised guide may be viewed and downloaded from HCA’s Provider billing guides and fee schedules webpage.
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