Updates to the COVID-19 vaccine clinical policy

Washington State Health Care Authority sent this bulletin at 04/13/2021 10:43 AM PDT

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Apple Health (Medicaid) Provider Alert

Attention providers:

What changed?

Family Planning Only clients - Retroactive to dates of service on and after April 1, 2021, COVID-19 vaccine administration is a covered service for Family Planning Only clients.

Roster billing for COVID-19 vaccine administration – The Health Care Authority (HCA) is implementing a system change to allow for roster billing for COVID-19 vaccine administration. The system change will be in place by May 1, 2021. Please see the ProviderOne Billing and Resource Guide for instructions on how to create a claim template and to submit template billing. This policy is retroactive to dates of service on and after April 1, 2021. However, do not bill until May 1, 2021 and after.

These policies are applicable to both fee-for-service (FFS) providers and HCA-contracted managed care organizations (MCOs).

HCA published revisions to the Apple Health (Medicaid) COVID-19 vaccine clinical policy to reflect these updates

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

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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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.