Hca Pay Stubs Online . See the NPI Registry Public Search for more information. Washington Apple Health (Medicaid) Physician-Related Services/Health Care Professional Services . Wa Hca Fee Schedule. Hca Washington Medicaid Fee Schedule. Includes medical and health care services provided to inmates inside or outside of Department of Corrections (DOC) prison facilities. Please see the below resources for claims and billing information related to offsite health care services. To find a ProviderOne ID for an inmate, in ProviderOne go to the client tab and click on benefit inquiry. These billing instructions are for offsite professional providers, facilities, and hospitals. The annual fee is $50.00. Use the ProviderOne portal to see if a client is eligible for the service and the billing guides and fee schedules to determine if a PA is required. Hca Pay Grades . The annual fee is $16.00. 2 . Use this tool to search by procedure code and year to find the authorized fees for billing L&I. Hca … For dates of services prior to 9/1/2012, you may continue to send paper claims to: Department of Corrections, Medical Disbursement Unit, PO BOX 41107 Olympia, WA 98504–1107. NIS Not priced by the current Physician Fee Schedule, or RVUs not included in RBRVS NL Payment information specific to procedure code not listed on state Medicaid website or physician fee schedule. The effective date and revision history are now See Access to Baby and Child Dentistry (ABCD). This request form MUST be the initial page when you submit your request. www.hca.wa.gov. fee when the client is at home, providers must use HCPCS code Q3014 and modifier CR. Washington Apple Health (Medicaid) Physician-Related Services/Health Care Professional Services . Below are the National Provider Identifier (NPI) and ProviderOne identification numbers for each Washington State Department of Corrections (DOC) prison facility. Clarification of policy for payment of services for teaching physicians. Physician fee schedule payment for services of teaching physicians. The following items are found in other guides and no longer listed separately: Jump to the first list item for each letter: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z. Coronavirus (COVID-19)—provider information, billing and policy, and telemedicine: Please see our Information about novel coronavirus (COVID-19) webpage for daily updates regarding COVID-19. For Apple Health clients and clients of the Developmental Disabilities Administration. For detailed billing and coverage information, refer to Billing Instructions and the Offender Health Plan (OHP). July 1, 2020 . Hca Pay Grades . October 1, 2012 F.1 Collagen Implants Add code L8604. Washington State Hca Fee Schedule. Medicaid Fee Schedules by State. Hca … Refer to this section for claims and status information related to services provided while an inmate is in an inpatient or outpatient status in the hospital, or to transport an inmate to and/or from an offsite hospital. Provider Notice 14-42 Dear Provider, Effective for claims with dates of service on and after July 1, 2014, Washington Apple Health (Medicaid), administer ed by the Health Care Authority (agency), is publishing a revised Physicians-Related Services/Health Care Professional Provider Guide and updated Physician-Related Services Fee Schedule. Visit our Forms and publications page to download authorization forms. Neither the OHP or the Formulary are a contract or a guarantee of reimbursement for services provided to inmates. For more information about the 2019 Novel Coronavirus situation, please visit our COVID-19 page. Hca Pay Stubs Online . Future SPAs will be developed as each update becomes due, and copies may be requested as soon as they are available. This policy is effective as of 3/1/20. Refer to the special notes under the fee schedule for more information. Medicare Dec 11, 2020. Physician’s Services (anticipated for July 1, 2017) The Agency is in the process of drafting SPA 17-0004 to reflect January 1, 2017, fee schedule updates; a copy will be provided on request as soon as it becomes available. Hca Medicaid Fee Schedule. Washington State Health Care Authority Medicaid Provider Guide Home Health Services ... guides, provider notices, fee schedules). Private insurance or third-party liability, other than agency-contracted managed care. Applicants who have applied but not paid in full before July 1, 2018, will pay the full $137 examination fee. Two full past years and the current year's fee schedules are posted on this webpage. Wa Hca Fee Schedule. If you need an accommodation or require documents in another format, please call 1-800-562-3022. Make sure to check the Updates & Corrections tab for any changes to the Payment Policies or Fee Schedules.. Use the following Fee Schedules and Payment Policies by year: 2020 Fee Schedules and Payment Policies. Centers ….. Fees are subject to change without notice. Hca Washington Medicaid Fee Schedule. In some cases, the system will show the subscriber does not have a plan identified (reject reason code 78), however, the system will show the ProviderOne ID number in the client demographic information section on the left side of the screen if one has been assigned to the inmate. If an actual or apparent conflict between this document and an HCA rule arises, HCA rules apply. After reviewing your application, we may contact you with additional questions. There is a convenience fee to apply online. The CY 2018 Medicare Physician Fee Schedule Final Rule was placed on display at the Federal Register on November 2, 2017. Healthcare Providers Claims & Billing. Please note if you have not signed a contract with the Department for dates of service September 1, 2012 and after, you are still required to bill through ProviderOne, and will be reimbursed at the Medicaid rates. This page contains billing guides, fee schedules, and additional billing materials to help you submit: Notice: Past billing guides may have broken links. Hca Physician Fee Schedule. After you complete a service, you file claims through the ProviderOne portal. Vision hardware fee schedule is available through the ESD contract. Washington State Health Care Authority Medicaid Provider Guide ... Fee Schedule ..... F.3 Section G: Billing and Claim Forms What Are the General Billing Requirements ... reviewed and signed by both a physician and a home health agency provider, that Fee schedule for home care aide credential. January 1, 2021 to present — Neurodevelopmental centers billing guide, October 1, 2020 to December 31, 2020 — Neurodevelopmental centers billing guide, January 1, 2020 to March 31, 2020 — Neurodevelopmental centers billing guide, View all neurodevelopmental centers billing guides, January 1, 2021 to present — Neurodevelopmental centers fee schedule, July 1, 2020 to December 31, 2020 — Neurodevelopmental centers fee schedule, April 1, 2020 to June 30, 2020 — Neurodevelopmental centers fee schedule, View all neurodevelopmental centers fee schedules, Nondurable medical supplies and equipment, January 1, 2019 to March 31, 2019 — Nondurable medical supplies and equipment billing guides, July 1, 2018 to December 31, 2018 — Nondurable medical supplies and equipment billing guides, View all nondurable medical supplies and equipment billing guides, January 1, 2019 to March 31, 2019 — Nondurable medical supplies and equipment fee schedule, January 1, 2018 to December 31, 2018 — Nondurable medical supplies and equipment fee schedule, January 1, 2017 to December 31, 2017 — Nondurable medical supplies and equipment fee schedule, View all nondurable medical supplies and equipment fee schedules, January 1, 2021 to present — Nursing facilities billing guide, October 1, 2020 to December 31, 2020 — Nursing facilities billing guide, April 1, 2020 to September 30, 2020 — Nursing facilities billing guide, View all nursing facilities billing guides, October 1, 2020 to present — Orthodontic service billing guide, February 8, 2020 to September 30, 2020 — Orthodontic service billing guide, January 1, 2020 to February 7, 2020 — Orthodontic service billing guide, View all orthodontic services billing guides, January 1, 2021 to present — Outpatient hospital services billing guide, October 1, 2020 to December 31, 2020 — Outpatient hospital services billing guide, July 1, 2020 to September 30, 2020 — Outpatient hospital services billing guide, January 1, 2021 present - OPPS fee schedule, July 1, 2020 to September 30, 2020 — OPPS fee schedule, April 1, 2020 to June 30, 2020 — OPPS fee schedule, January 1, 2021 to present — Outpatient rehabilitation billing guide, October 20, 2020 to December 31, 2020 — Outpatient rehabilitation billing guide, October 1, 2020 to October 19, 2020 — Outpatient rehabilitation billing guide, View all Outpatient Rehabilitation Program billing guides, January 1, 2021 to present — Outpatient rehabilitation fee schedule, July 1, 2020 to December 31, 2020 — Outpatient rehabilitation fee schedule, April 1, 2020 to June 30, 2020 — Outpatient rehabilitation fee schedule, View all Outpatient Rehabilitation Program fee schedules, May 22, 2020 to November 16, 2020 - Social services blanket codes, Pharmacy special services, vaccine administration, and compliance packaging, July 1, 2020 to present — Pharmacy Special Services fee schedule, July 1, 2019 to June 30, 2020 — Pharmacy Special Services fee schedule, July 1, 2018 to June 30, 2019 — Pharmacy Special Services fee schedule, View all pharmacy special services fee schedules, January 1, 2021 to present — Physician-related services/health care billing guide, October 1, 2020 to December 31, 2020 — Physician-related services/health care billing guide, September 1, 2020 to September 30, 2020 — Physician-related services/health care billing guide, View all physician-related/professional services billing guides, January 1, 2021 to present — Physician-related services fee schedules, October 1, 2020 to December 31, 2020 — Physician-related services fee schedule, July 1, 2020 to September 30, 2020 — Physician-related services fee schedule, View all physician-related/professional services fee schedules, January 1, 2021 to present — Enhanced pediatric fee schedule, July 1, 2020 to December 31, 2020 — Enhanced pediatric fee schedule, January 1, 2020 to June 30, 2020 — Enhanced pediatric fee schedule, View all enhanced pediatric fee schedules, January 1, 2021 to present — Opioid Use Disorder fee schedule, July 1, 2020 to December 31, 2020 — Opioid Use Disorder fee schedule, July 1, 2019 to June 30, 2020 — Opioid Use Disorder fee schedule, View all medication for opioid use disorder fee schedules, July 1, 2020 to present — Conversion factors, July 1, 2019 to June 30, 2020 — Conversion factors, July 1, 2018 to June 30, 2019 — Conversion factors, Planned home births and births in birth centers, January 1, 2021 to present — Planned home births and births in centers billing guide, October  1, 2020 to December 31, 2020 — Planned home births and births in centers billing guide, July  1, 2020 to September 30, 2020  — Planned home births and births in centers billing guide, View all planned home births billing guides, July 1, 2020 to present — Planned home births and births in centers fee schedule, April 1, 2020 to June 30, 2020 — Planned home births and births in centers fee schedule, October 25, 2019 to March 31, 2020 — Planned home births and births in centers fee schedule, View all planned home births fee schedules, View all Prenatal genetic counseling  billing guides, July 1, 2020 to present — Prenatal diagnosis genetic counseling fee schedule, July 1, 2017 to June 30, 2020 — Prenatal diagnosis genetic counseling fee schedule, July 1, 2016 to June 30, 2017 — Prenatal diagnosis genetic counseling fee schedule, View all prenatal diagnosis genetic counseling fee schedules, January 1, 2021 to present - Prescription drug program billing guide, October 1, 2020 to December 31, 2020 - Prescription drug program billing guide, August 6, 2020 to September 30, 2020 - Prescription drug program billing guide, December 1, 2020 to present - Expedited authorization codes and criteria table, July 1, 2020 to November 30, 2020 — Expedited authorization codes and criteria table, January 1, 2020 to June 30, 2020 — Expedited authorization codes and criteria table, November 1, 2019 to December 31, 2019 — Expedited authorization codes and criteria table, October 1, 2020 to present - Private duty nursing for children billing guide, July 17, 2020 to September 30, 2020 - Private duty nursing for children billing guide, January 1, 2020 to July 16, 2020 — Private duty nursing for children billing guide, View all private duty nursing for children billing guides, January 1, 2020 to present — Private duty nursing fee schedule, July 1, 2016 to December 31, 2019 — Private duty nursing fee schedule, July 1, 2007 to June 30, 2016 — Private duty nursing fee schedule, January 1, 2021 to present — Professional administered drug fee schedule, October 1, 2020 to December 31, 2020 — Professional administered drug fee schedule, July 1, 2020 to September 30, 2020 — Professional administered drug fee schedule, View all professional administered drugs fee schedules, January 1, 2021 to present — Prosthetic and orthotic devices billing guide, October 1, 2020 to December 31, 2020 — Prosthetic and orthotic devices billing guide, July 1, 2020 to September 30, 2020 — Prosthetic and orthotic devices billing guide, View all prosthetic and orthotics billing guides, October 1, 2020 to present — Prosthetic and orthotics fee schedule, July 1, 2020 to September 30, 2020 — Prosthetic and orthotics fee schedule, January 1, 2020 to June 30, 2020 — Prosthetic and orthotics fee schedule, View all prosthetic and orthotics fee schedules, May 22,  2020 to November 16, 2020 — Social services blanket codes, October 1, 2020 to present — Respiratory care billing guide, April 1, 2020 to September 30, 2020 — Respiratory care billing guide, January 1, 2020 to March 31, 2020 — Respiratory care billing guide, October 1, 2020 to present — Respiratory care fee schedule, July 1, 2020 to September 30, 2020 — Respiratory care fee schedule, April 1, 2020 to June 30, 2020 — Respiratory care fee schedule, January 1, 2021 to present — Rural health clinics billing guide, October 1, 2020 to December 31, 2020 — Rural health clinics billing guide, July 1, 2020 to September 30, 2020 — Rural health clinics billing guide, January 1, 2021 to present — Encounter rates, October 1, 2020 to December 31, 2020 — Encounter rates, July 1, 2020 to September 30, 2020 — Encounter rates, January 1, 2021 to present — RHC enhancement rates, October 1, 2020 to December 31, 2020 — RHC enhancement rates, July 1, 2020 to September 30, 2020 — RHC enhancement rates, October 1, 2020 to present--SBHS billing guide, August 1, 2020 to September 30, 2020 - SBHS billing guide, January 1, 2020 to July 31, 2020 — SBHS billing guide, July 1, 2020 to present — SBHS fee schedule, January 1, 2020 to June 30, 2020 — SBHS fee schedule, July 1, 2019 to December 31, 2019 — SBHS fee schedule, October 1, 2020 to present — Sleep centers billing guide, January 1, 2020 to September 30, 2020 — Sleep centers billing guide, October 1, 2019 to December 31, 2019 — Sleep centers billing guide, July 1, 2020 to present — Sleep centers fee schedule, January 1, 2020 to June 30, 2020 — Sleep centers fee schedule, July 1, 2019 to December 31, 2019 — Sleep centers fee schedule, January 1, 2021 to present - Sterilization supplemental billing guide, October 1, 2020 to December 31, 2020 — Sterilization supplemental billing guide, July 1, 2020 to September 30, 2020  — Sterilization supplemental billing guide, Physician-related/Professional Services Billing Guide, Sterilization Consent Form (HHS-687) (English), Sterilization Consent Form (HHS-687-1) (Spanish), January 1, 2021 to present — Substance use disorder billing guide, August 1, 2020 to December 31, 2020 — Substance use disorder billing guide, July 1, 2020 to July 31, 2020 — Substance use disorder billing guide, View all SUD (FFS outside BHO process) billing guides, January 1, 2021 to present — Substance use disorder fee schedule, October 1, 2020 to December 31, 2020 — Substance use disorder fee schedule, January 1, 2020 to September 30, 2020 — Substance use disorder fee schedule, View all substance use disorder fee schedules, January  1, 2021 to present — Tribal health billing guide, October  1, 2020 to December 30, 2020 — Tribal health billing guide, April 1, 2020 to September 30, 2020 — Tribal health billing guide, View all Tribal Health Program billing guides, January 1, 2021 to present — Tribal health program fee schedule, April 1, 2020 to December 31, 2020 — Tribal health program fee schedule, January 1, 2020 to March 31, 2020 — Tribal health program fee schedule, Vision hardware for clients 20 years of age and younger, October 1, 2020 to present — Vision hardware billing guide, July 1, 2020 to September 30 2020  — Vision hardware billing guide, April 1, 2020 to June 30, 2020 — Vision hardware billing guide, Guidance for hospitals in billing MCOs for services provided to newborns, Website feedback: Tell us how we’re doing, Children’s mental health services and psychology (see, Interpreter services (no billing guide, see our, Occupational therapy, physical therapy, and speech/audiology (see, (Fee-for-service benefits provided outside of the BHO process). Do not bill using HCPCS code G0463 for the same date of service. A. Maximum allowable fees are established and updated using the Resource Based Relative Value Scale (RBRVS) methodology as adopted in the Medicare Fee Schedule Data Base (MFSDB). Hca Medicaid Fee Schedule. All agency-contracted managed care organizations (MCOs) and the fee-for-service (FFS) program use the Apple Health PDL. May 20,2013 – Medicaid. If you have not read and agreed to the AMA copyright statement, please read it now. Codes that are not included in the below fee schedules are not covered by the Department. Refer to the current Physician-related/professional services for information regarding blood, blood products, and related services. Box 1099 Olympia, WA 98507-1099. www.medicaid.gov. Although every effort is made to ensure the accuracy of the fees, changes or corrections may occur throughout the year. Hca Pay Stubs Online . With the passage of House Bill 2803 and its enactment into law, providers of hospital services (inpatient or outpatient) must bill and be paid through the HCA ProviderOne system under the rates and methodologies in use by the state Medicaid program. First-time test takers will pay $137. Hca Pay Grades . Check for any follow-up emails, including checking your spam and junk mail folder. HCA is committed to providing equal access to our services. The Department published a statewide hearing aid fee schedule for Hearing Services HCPCS codes V5000-V5999, effective 8/1/2014 through 6/30/2015. If you have not read and agreed to the AMA copyright statement, please read it now. Hca … Fax your request to: 866 -668 -1214. Please note several codes require prior authorization and any by report codes require submissions of documentation with the claim. All coverage and payments are subject to pre-authorization requirements. For fee schedule and rate questionsEmail: ProfessionalRates@hca.wa.gov, For all other provider questionsMedical Assistance Customer Service Center (MACSC)Online: web formPhone: 1-800-562-3022, Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. For previous versions, email us applehealthpharmacypolicy@hca.wa.gov. Ambulance transports (to and from hospitals) by private companies must be billed through the ProviderOne system. February 1, 2020 . For step-by-step instructions on completing a PA, visit our Prior authorization (PA) page. Do you need a barcode cover sheet? Contact us for previous fee schedules. For questions about rates or fee schedules, email ProfessionalRates@hca.wa.gov. Billing Guide . The Offender Health Plan (OHP) defines which health care services are available to inmates, as well as services that are limited or not available. Fee-for Services Non-Tribal Behavioral Health Providers for American Indians & Alaska Fee for Service Program - Frequently Asked Questions Providers and Rates See the Health Care Authority (HCA) for more information. Fax the request to: 866-668-1214. Paper claims submitted to the Department for these dates of service will be denied. Physician-Related Services/Health Care Professional Services . Questions regarding coverage or eligibility for DOC inmates should be referred to the Medical Disbursement Unit. Billing Guide . Physician Services . January 1, 2021 to present — Physician-related services fee schedules (updated December 28, 2020) October 1, 2020 to December 31, 2020 — Physician-related services fee schedule (updated November 24, 2020) July 1, 2020 to September 30, 2020 — Physician-related services fee schedule … DOC Pharmaceutical Management & Formulary Manual, Physician Related and Professional Healthcare Services, Durable Medical Equipment, Prosthetics, Orthotics and Supplies, Inmate Healthcare Providers Billing Instructions, Sustainability & Environmental Performance, Copyright © 2021 Washington State Department of Corrections. The most recent guide information in this section years and the Offender Health Plan ( OHP ) provider guide Health... 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In full before July 1, 2018 throughout the year at 1-800-562-3022 home, providers must HCPCS... Effort is made to ensure this guide * this publication takes effect November,. Agency ’ s Apple Health PDL regarding blood, blood products, and date of birth in section! Coverage and payments are subject to pre-authorization requirements billing changes, and copies may be requested as soon they... Download the Pharmacy information authorization form ( 13-835A ) when the client tab click! Barcode cover sheets page to find rate information and the current Physician-related/professional services information. Center ( MACSC ) online or at 1-800-562-3022 teaching physicians Coronavirus situation, read! Of documentation with the claim clients of the billing guides and fee schedules posted. G0463 for the same date of birth in this section and clients of fees! 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