Community health worker WAC and billing guide now available

Washington State Health Care Authority sent this bulletin at 04/21/2025 08:00 AM PDT

April 21, 2025

Providers, don’t forget! Our mailing list revisions are complete. Update your subscriptions to get the information you need.

Community health worker services WAC

The Washington Administrative Code (WAC) for the community health worker (CHW) services Apple Health (Medicaid) benefit is now available. The WAC establishes rules for the benefit, including scope of practice and provider requirements.

View CHW services WAC

CHW billing guide

The billing guide provides step-by-step instructions for how to bill for CHW services including codes, rates, documentation, and prior authorization processes. The CHW Medicaid benefit is now available on the Washington State Register. This marks an important milestone in the implementation of CHW services under Apple Health.

View CHW services billing guide

CHW frequently asked questions

The CHW benefit allows community health workers to provide preventive services under the supervision of a licensed practitioner. The services will help address health-related social needs and improve access to care for high-risk conditions for Washington’s Apple Health population.

Can CHW services be billed now that the WAC and billing guide are published?

No. CHW services cannot be billed until the benefit goes live July 1, 2025.

How should providers get ready?

Providers should review the CHW WAC and billing guide, prepare for provider enrollment, and see the CHW webpage for technical assistance opportunities.

Enroll as a billing provider

How do I stay informed?

Can’t access the links? Add “lnks.gd” to the allowlist of your content blocking software.

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

Disclosure notice

All messages we send via GovDelivery are subject to public disclosure, as are the names and email addresses of those who sign up for email notifications.

Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.