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Attention providers
What is changing?
Effective for dates of service on and after October 1, 2026, the Health Care Authority (HCA) has updated the Physician-Related Services/Health Care Professional Services Billing Guide. Updates include the following:
- Removed the superseded information regarding COVID-19 molecular and antigen testing from the guide. HCA informed providers about this change in July 2026.
- Added coverage of HCPCS code S2068 (Breast diep or siea flap) to the Breast removal and breast reconstruction section of the guide.
- Updated the billing code for decipher prostate genomic testing, replacing CPT® code 81479 with the more specific CPT® code 81542.
- Moved multiple sections in the Drugs Professionally Administered section to HCA’s Prescription Drug Program Billing Guide.
- Removed the prior authorization requirement from transient elastography, deleting all references to this requirement from the guide. Prior authorization for this service is no longer required.
- Changed the form number for the Attestation for Collaborative Care Model form to HCA 09-003.
For more details, refer to the What has changed table inside the updated guide, which is located on HCA’s Provider billing guides and fee schedules webpage.
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