PM&R and LTAC prior authorization (PA) requests

Washington State Health Care Authority sent this bulletin at 04/10/2025 01:56 PM PDT

April 10, 2025

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Apple Health (Medicaid) Provider Alert

Attention Physical Medicine & Rehabilitation (PM&R) and Long-term Acute Care (LTAC) Program Providers:

Effective for dates of service on and after July 1, 2025, the Health Care Authority (HCA) requires that prior authorization (PA) requests for PM&R and LTAC services be submitted online through direct data entry in ProviderOne. The PMR/LTAC-specific fax line will be discontinued on August 1, 2025. The Authorization Services Office (ASO) fax line will be available only as a back-up method for submitting PA requests.

These updates will be reflected in the PM&R and LTAC billing guides to be published July 1, 2025.

See the current PM&R Billing Guide for submitting PA requests by fax.

See the current LTAC Billing Guide for submitting PA requests by fax and direct data entry in ProviderOne.

For more information on prior authorization, see the Step-by-step guide for prior authorization | Washington State Health Care Authority.

Forms may be downloaded from Forms and publications | Washington State Health Care Authority.

For specific PA questions, contact the Authorization Services Office (ASO).

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.

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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.

PM&R and LTAC prior authorization (PA) requests

Apple Health (Medicaid) Provider Alert

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About the Health Care Authority (HCA)

Disclosure notice

Nondiscrimination