New billing requirements for associate-level providers, effective 1-1-2026

Washington State Health Care Authority sent this bulletin at 12/12/2025 03:01 PM PST

December 12, 2025

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Apple Health (Medicaid) Provider Alert

Attention providers:

Effective for claims with dates of service on or after January 1, 2026, the Health Care Authority is updating taxonomy and claim note requirements for licensed, associate-level behavioral health providers when submitting claims for clients who are dually eligible for Medicare and Apple Health (Medicaid). Licensed associates cannot bill Medicare. The following providers must use the appropriate associate-level taxonomy and include the required claim note when billing Medicaid claims:

Licensed advanced social worker associate (LASWA)
Licensed independent clinical social worker associate (LSWAIC)
Licensed marriage and family therapist associate (LMFTA)
Licensed mental health counselor associate (LMHCA)
Psychological associates

Full details, including the specific taxonomies and claim note language, will be provided in the January 1, 2026, Mental Health Billing Guide, Part 1 update. See the Provider billing guides and fee schedules webpage for updated billing guides.

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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