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Effective January 1, 2025, the Health Care Authority (HCA) amended Washington Administrative Code (WAC 182-545-200) to expand payment criteria for developmental services to allow providers, including Neurodevelopment Centers (NDC), to offer care in community settings for children six years old or younger.
Why did HCA make this change?
The updated rule addresses a gap for children ages three to five years old. Outpatient rehabilitation providers are now permitted to provide care in a community setting (including daycare) up to age 6. Children who continue to have developmental needs and remain in childcare until age 6 will no longer have a gap in service before entering kindergarten.
What are developmental services?
Outpatient rehabilitation services, such as:
- Occupational therapy
- Physical therapy
- Speech therapy
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Historically, WAC 182-545-200 limited payment for developmental services to care provided in clinic based settings, unless children were age two or younger.
These services are already covered by Apple Health. The change does not impact eligibility for care, types of services allowed, or the reimbursement rate for these services. The only change is allowing a place of service that was previously not allowed.
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