Please choose the appropriate provider type or specialty below to view the PROMISe handbook and billing guide appropriate for you. Receive accurate payments for covered services. Discontinued 3/31/2013. endstream endobj startxref See Physician-related/professional services. website belongs to an official government organization in the United States. <>/Metadata 1700 0 R/ViewerPreferences 1701 0 R>> Notice: Past billing guides may have broken links. View nv_billingguidelines_pt14.pdf from FRE 212 at Northern Virginia Community College. Home Health. Vision hardware fee schedule is available through the ESD contract. %PDF-1.7 2 0 obj % After you complete a service, you file claims through the ProviderOne portal. 4 0 obj Provider Type 14 Billing Guide Behavioral Health Outpatient Treatment State policy The Medicaid Services Manual Pharmacy. The UPIN must be present on inpatient Part A bills with a "Through" date of January 1, 1992, or later. Provider Type 30 and 83 Personal Care Services - 8/15/20* Provider Type 32. endobj Strengthen the current instructions that apply to nearly all types of providers. Last Updated Thu, 27 Feb 2020 09:03:14 +0000. OnOctober 1, 2016, we implemented a paperless billing policy where all Apple Health (Medicaid) providers (excluding Tribal billing offices) are required to submitelectronic claims for Apple Health (Medicaid) services. &-@10mk_q lock 0 Use our billing guides and fee schedules to determine if a PA is required and assist in filing claims. <> The guide is intended to: Strengthen the current instructions that apply to nearly all types of providers. 1 Provider Type 14 Billing Guide Behavioral Health Outpatient Treatment State policy The Medicaid Services Manual (MSM) is on the Division of Health Care Financing and policy (DHCFP) website at (select Manuals from the Resources webpage). If you are not receiving regular invoices via email, please contact our billing team to ensure that your contact and billing information is correct. Provider Type 14 Billing Guide . stream Fax the request to: 866-668-1214. Before you provide certain services, you will need to submit authorization request forms. This page contains billing guides, fee schedules, and additional billing materials to help you submit: Coronavirus (COVID-19) information. Hospice Reimbursement. 3]V8b{i 23NfnC~9SfqgV-y For questions about rates or fee schedules, email ProfessionalRates@hca.wa.gov. An invoice, bill or tab is a commercial document issued by a seller to a buyer relating to a sale transaction and indicating the products, quantities, and agreed-upon prices for products or services the seller had provided the buyer.. Payment terms are usually stated on the invoice. hZOI?e~9)(~VH)&b{pt"guW_u7X"Y#- pR)! Do you need a barcode cover sheet? On-campus facilities (within 250 yards) must follow all rules stated under Section (d). x]rFwa.-WUdQ$es$jI@)5@J$f5t"K$I~}l$g\gtFW,/&/zY2s1|)foxm9Za Learn about changes to rates and updates to our billing guides. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 19 0 R 20 0 R 26 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 41 0 R 42 0 R 43 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Acute Inpatient Prospective Payment System (IPPS) Hospital; Ambulance; . Questions? Add Acquisitions filter . Official websites use .govA https:// Nursing services, physician services, and drugs and biologicals must Visit our Forms and publications page to download authorization forms. Heres how you know. All Providers must ensure they are billing for services covered under their assigned specialty and category of service. hbbd``b`^$[u bv $XAJtA Ab| +9bu nw,`[$@F) Nk+d+j%#88o _e For questions about billing guides, contact the Medical Assistance Customer Service Center (MACSC) online or at 1-800-562-3022. %%EOF How do I notify PEBB that my loved one has passed away? Receive accurate payments for covered services. Sign up to get the latest information about your choice of CMS topics. Respond to provider requests for more step-by-step reference materials for ProviderOne. Ambulatory Surgical Centers (ASC) Ambulance Services. Share sensitive information only on official, secure websites. Use our billing guides and fee schedules to determine if a PA is required and assist in filing claims. ^ T`` WaT BROWSE BY PROVIDER TYPE. Critical Access Hospitals. Provider Type 32 Ambulance, Spec 249 Comm Paramed Provider Type 32 Ambulance, Spec 932 Ambulance Air or Ground Provider Type 33 Durable Medical Equipment, Prosthetics, Orthotics & Supplies; Provider Type 34 Therapy They are presented here for your convenience. For fee schedule and rate questionsEmail:ProfessionalRates@hca.wa.gov, For all other provider questionsMedical Assistance Customer Service Center (MACSC)Online: secure formPhone: 1-800-562-3022, Website feedback: Tell us how were doing, Copyright 2022 Washington Health Care Authority, I help others apply for & access Apple Health, Medically Intensive Children's Program (MICP), Behavioral health services for prenatal, children & young adults, Wraparound with Intensive Services (WISe), Behavioral health services for American Indians & Alaska Natives (AI/AN), Substance use disorder prevention & mental health promotion, Introduction overview for general eligibility, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services & supports (LTSS) manual, Medical plans & benefits (including vision), Life, home, auto, AD&D, LTD, FSA, & DCAP benefits. 678 0 obj <>/Filter/FlateDecode/ID[<460207C96267AC43B00704173EA05454>]/Index[648 72]/Info 647 0 R/Length 121/Prev 128865/Root 649 0 R/Size 720/Type/XRef/W[1 2 1]>>stream Rural Health Clinics (RHC) and Federally Qualified Health (FQHC) Ground Ambulance Upper Payment Limit (UPL) endobj 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. Arizona Complete Health-Complete Care Plan has noticed a significant increase in provider claims denying for the servicing provider's Provider Type being invalid to bill for the procedure code (s). means youve safely connected to the .gov website. Bill in a timely fashion. Life, home, auto, AD&D, LTD, & FSA benefits, Overview of prior authorization (PA), claims & billing, Step-by-step guide for prior authorization (PA), Program benefit packages & scope of services, First Steps (maternity support & infant care), Ground emergency medical transportation (GEMT), Substance use disorder (SUD) consent management guidance, Enroll as a health care professional practicing under a group or facility, Enroll as a billing agent or clearinghouse, Find next steps for new Medicaid providers, Washington Prescription Drug Program (WPDP), Governor's Indian Health Advisory Council, Analytics, research & measurement (ARM) data dashboard suite, Foundational Community Supports provider map, Medicaid maternal & child health measures, Washington State All Payer Claims Database (WA-APCD), Personal injury, casualty recoveries & special needs trusts, Information about novel coronavirus (COVID-19), Information about novel coronavirus (COVID-19) webpage, October 1, 2022 to present ABCD billing guide, July 1, 2022 to September 30, 2022 ABCD billing guide, April 15, 2022 to June 30, 2022 ABCD billing guide, July 1, 2022 to present Acute physical medicine and rehabilitation billing guide, October 1, 2020 to June 30, 2022 Acute physical medicine and rehabilitation billing guide, January 1, 2020 to September 30, 2020 Acute physical medicine and rehabilitation billing guide, View all acute physical medicine and rehabilitation billing guides, July 1, 2022 to present Alien Medical Program billing guide, January 1, 2022 to June 30, 2022 Alien Medical Program billing guide, April 1, 2021 to December 31, 2021 Alien Medical Program billing guide, View all Alien Medical Program emergency assistance billing guides, January 1, 2021 to present Ambulance transportation billing guide, July 1, 2020 to December 31, 2020 Ambulance transportation billing guide, April 1, 2020 to June 30, 2020 Ambulance transportation billing guide, View all ITA transportation billing guides, July 1, 2022 to present Ground Emergency Medical Transportation (GEMT) billing guide, October 1, 2020 to June 30, 2022 Ground Emergency Medical Transportation (GEMT) billing guide, January 1, 2020 to September 30, 2020 Ground Emergency Medical Transportation (GEMT) billing guide, July 1, 2021 to present Ambulance transportation, February 29, 2020 to June 30, 2021 Ambulance transportation, July 1, 2019 to February 28, 2020 Ambulance transportation, December 1, 2016 to June 30, 2019 Ambulance transportation, January 1, 2006 to November 30, 2016 Ambulance transportation, July 1, 2022 to present ACS billing guide, July 1, 2021 to June 30, 2022 ASC billing guide, October 1, 2020 to June 30, 2021 ASC billing guide, April 1, 2022 to present ASC fee schedule, October 1, 2021 to March 31, 2022 ASC fee schedule, March 1, 2021 to September 30, 2021 ASC fee schedule, October 1, 2022 to present ABA billing guide, August 1, 2022 to September 30, 2022 ABA billing guide, April 29, 2022 to July 31, 2022 ABA billing guide, July 1, 2022 to present ABA fee schedule, July 1, 2021 to June 30, 2022 ABA fee schedule, July 1, 2020 to June 30, 2021 ABA fee schedule, ABA COE fee-for-service provider directory, July 1, 2022 to present Blood bank fee schedule, July 1, 2021 to June 30, 2022 Blood bank fee schedule, July 1, 2020 to June 30, 2021 Blood bank fee schedule, View all Blood Bank services fee schedules, January 1, 2022 to present CUP program billing guide, October 1, 2020 to December 31, 2021 CUP women program billing guide, July 1, 2019 to September 30, 2020 CUP women program billing guide, Inpatient Prospective Payment System (IPPS), October 1, 2020 to present Childbirth education billing guide, April 1, 2019 to September 30, 2020 Childbirth education billing guide, October 1, 2017 to March 31, 2019 Childbirth education billing guide, View all childbirth education billing guides, January 1, 2007 to present Childbirth education, July 1, 2022 to present Chiropractic services billing guide, October 1, 2020 to June 30, 2022 Chiropractic services billing guide, January 1, 2020 to September 30, 2020 Chiropractic services billing guide, View all chiropractic services for children billing guides, July 1, 2022 to present Chiropractic services for children fee schedule, July 1, 2021 to June 30, 2022 Chiropractic services for children fee schedule, July 1, 2020 to June 30, 2021 Chiropractic services for children fee schedule, View all chiropractic services for children fee schedules, July 1, 2022 to present CRT products and services billing guide, January 1, 2022 to June 30, 2022 CRT products and services billing guide, October 1, 2020 to December 31, 2021 CRT products and services billing guide, July 1, 2022 to present CRT fee schedule, April 1, 2022 to June 30, 2022 CRT fee schedule, July 1, 2021 to March 31, 22 CRT fee schedule, October 1, 2022 to present Social services blanket codes, September 1, 2021 to September 30, 2022 Social services blanket codes, November 17, 2020 to August 31, 2021 Social services blanket codes, July 1, 2022 to present COVID-19 fee schedule, January 1, 2022 to June 30, 2022 COVID-19 fee schedule, July 1, 2021 to December 31, 2021 COVID-19 fee schedule, October 12, 2022 to present Apple Health COVID-19 vaccine policy, September 15, 2022 to October 11, 2022 Apple Health COVID-19 vaccine policy, August 1, 2022 to September 14, 2022 Apple Health COVID-19 vaccine policy, September 14, 2022 to present Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, August 19, 2022 to September 13, 2022 Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, May 10, 2022 to August 18, 2022 Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, April 12, 2022 to May 9, 2022 Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, March 23, 2022 to April 11, 2022 Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, View all Monoclonal Antibody Treatment COVID-19 clinical policies, March 4, 2022 to present Apple Health COVID-19 testing clinical policy, January 24, 2022 to March 3, 2022 Apple Health COVID-19 testing clinical policy, October 1, 2021 to January 23, 2022 Apple Health COVID-19 testing clinical policy, View all COVID-19 testing clinical policies, Access to Baby and Child Dentistry (ABCD), October 1, 2022 to present Dental-related services program billing guide, August 1, 2022 to September 30, 2022 Dental-related services program billing guide, July 1, 2022 to July 31, 2022 Dental-related services program billing guide, July 1, 2022 to present Oral Health Connections pilot project billing guide, January 1, 2022 to June 30, 2022 Oral Health Connections pilot project billing guide, October 1, 2020 to December 31, 2021 Oral Health Connections pilot project billing guide, View all OHC pilot project billing guides, July 1, 2022 to present Mobile anesthesia for dental services billing guide, October 1, 2022 to present Dental program fee schedule, July 1, 2022 to September 30, 2022 Dental program fee schedule, January 1, 2022 to June 30, 2022 Dental program fee schedule, July 1, 2022 to present Diabetes education program billing guide, July 1, 2021 to June 30, 2022 Diabetes education program billing guide, April 1, 2021 to June 30, 2021 Diabetes education program billing guide, View all Diabetes Education Program billing guides, July 1, 2022 to present Diabetes education, July 1, 2021 to June 30, 2022 Diabetes education, July 1, 2020 to June 30, 2021 Diabetes education, View all diabetes education fee schedules, Medical Equipment and Supplies billing guide, January 1, 2019 to March 31, 2019 DME and non-CRT wheelchairs billing guide, October 1, 2018 to December 31, 2018 DME and non-CRT wheelchairs billing guide, July 1, 2018 to September 30, 2018 DME and non-CRT wheelchairs billing guide, Medical Equipment and Supplies fee schedules, January 1, 2019 to March 31, 2019 Other DME fee schedule, January 1, 2019 to March 31, 2019 Wheelchairs and accessories fee schedule, View all DME social services blanket codes, July 1, 2022 to present EPSDT program billing guide, April 1, 2022 to June 30, 2022 EPSDT program billing guide, April 1, 2021 to March 31, 2022 EPSDT program billing guide, July 1, 2022 to present EPSDT fee schedule, July 1, 2021 to June 30, 2022 EPSDT fee schedule, July 1, 2020 to June 30, 2021 EPSDT fee schedule, September 1, 2022 to present Enteral nutrition billing guide, July 1, 2022 to August 31, 2022 Enteral nutrition billing guide, April 1, 2021 to June 30, 2022 Enteral nutrition billing guide, View all enteral nutrition billing guides, July 1, 2022 to present Enteral nutrition fee schedule, July 1, 2021 to June 30, 2022 Enteral nutrition fee schedule, July 1, 2020 to June 30, 2021 Enteral nutrition fee schedule, July 1, 2022 to present Family planning billing guide, February 1, 2022 to June 30, 2022 Family planning billing guide, October 1, 2021 to January 31, 2022 Family planning billing guide, October 1, 2022 to present Family planning fee schedule, July 1, 2022 to September 30, 2022 Family planning fee schedule, January 1, 2022 to June 30, 2022 Family planning fee schedule, July 1, 2022 to present SRHP fee schedule, October 1, 2021 to June 30, 2022 SRHP fee schedule, Physician-Related Services/Health Care Professional Services Billing Guide, Physician administered drugs fee schedule, Family planning only program telemedicine services offered during the COVID-19 outbreak, Family planning client application (form 13-781), October 1, 2022 to present FQHC billing guide, August 1, 2022 to September 30,2022 FQHC billing guide, July 1, 2022 to July 31, 2022 FQHC billing guide, October 1, 2022 to present FQHC encounterrates, July 1, 2022 to September 30, 2022 FQHC encounter rates, April 1, 2022 to June 30, 2022 FQHC encounter rates, October 1, 2022 to present FQHC enhancement rates, July 1, 2022 to September 30, 2022 FQHC enhancement rates, April 1, 2022 to June 30, 2022 FQHC enhancement rates, August 1, 2022 to present Habilitative services program billing guide, July 1, 2022 to July 31, 2022 Habilitative services program billing guide, January 1, 2022 to June 30, 2022 Habilitative services program billing guide, View all habilitative services billing guides, July 1, 2022 to present Habilitative services, July 1, 2021 to June 30, 2022 Habilitative services, January 1, 2021 to June 30, 2021 Habilitative services, View all habilitative services fee schedules, April 1, 2022 to present Hearing hardware billing guide, November 1, 2020 to March 31, 2022 Hearing hardware billing guide, October 1, 2020 to October 31, 2020 Hearing hardware billing guide, July 1, 2022 to present Hearing hardware fee schedule, April 1, 2022 to June 30, 2022 Hearing hardware fee schedule, July 1, 2021 to March 30, 2022 Hearing hardware fee schedule, April 1, 2022 to present HIV/AIDS case management billing guide, April 1, 2021 to March 31, 2022 HIV/AIDS case management billing guide, October 1, 2020 to March 31, 2021 HIV/AIDS case management billing guide, July 1, 2018 to present HIV/AIDS case management, July 1, 2022 to present Home health (acute care services) billing guide, April 1, 2022 to June 30, 2022 Home health (acute care services) billing guide, February 1, 2022 to March 31, 2022 Home health (acute care services) billing guide, View all home health services billing guides, July 1, 2022 to present Home health fee schedule, January 1, 2022 to June 30, 2022 Home health fee schedule, July 1, 2021 to December 31, 2021 Home health fee schedule, View all home health services fee schedules, October 1, 2021 to present Home Infusion therapy billing guide, January 1, 2021 to September 30, 2021 Home Infusion therapy billing guide, October 1, 2020 to December 31, 2020 Home Infusion therapy billing guide, View all home infusion therapy and nutrition billing guides, October 1, 2022 to present Home infusion therapy/parenteral nutrition fee schedule, July 1, 2022 to September 30, 2022 Home infusion therapy/parenteral nutrition fee schedule, July 1, 2021 to June 30, 2022 Home infusion therapy/parenteral nutrition fee schedule, View all home infusion therapy/parenteral nutrition fee schedules, July 1, 2022 to present Hospice services billing guide, October 1, 2020 to June 30, 2022 Hospice services billing guide, January 1, 2020 to September 30, 2020 Hospice services billing guide, October 1, 2021 to September 30, 2022 Hospice fee schedule, October 1, 2020 to September 30, 2021 Hospice fee schedule, January 1, 2020 to July 1, 2020 Hospital-based inpatient detoxification billing guide, July 1, 2019 to December 31, 2019 Hospital-based inpatient detoxification billing guide, January 1, 2019 to June 30, 2019 Hospital-based inpatient detoxification billing guide, View all hospital-based inpatient detoxification billing guides, October 1, 2022 to present Inpatient hospital services billing guide, July 1, 2022 to September 30, 2022 Inpatient hospital services billing guide, April 1, 2022 to June 30, 2022 Inpatient hospital services billing guide, View all inpatient hospital billing guides, Guidance for billing MCOs for services provided to newborns, RAC Eligibility Codes for Healthy Options Blind/Disabled (HOBD) Clients, November 1, 2022 to present Interpreter services billing guide, April 1, 2022 to October 31, 2022 Interpreter services billing guide, October 1, 2021 to March 31, 2022 Interpreter services billing guide, July 1, 2022 to present Kidney center services billing guide, January 1, 2022 to June 30, 2022 Kidney center services billing guide, January 1, 2021 to December 31, 2021 Kidney center services billing guide, View all kidney center services billing guides, October 1, 2022 to present Kidney centers fee schedule, July 1, 2022 to September 30, 2022 Kidney centers fee schedules, April 1, 2022 to June 30, 2022 Kidney centers fee schedules, View all kidney center services fee schedules, July 1, 2022 to present Long-term care program billing guide, October 1, 2020 to June 30, 2022 Long-term care program billing guide, January 1, 2020 to September 30, 2020 Long-term care program billing guide, View all long-term acute care billing guides, August 1, 2022 to present MSS/ICM billing guide, July 1, 2022 to July 31, 2022 MSS/ICM billing guide, January 1, 2021 to June 30, 2022 MSS/ICM billing guide, July 1, 2020 to present MSS/ICM fee schedule, January 1, 2020 to June 30, 2020 MSS/ICM fee schedule, October 1, 2015 to December 31, 2019 MSS/ICM fee schedule, October 21, 2022 to present Medical Equipment and Supplies Billing Guide, October 1, 2022 to October 20, 2022 Medical Equipment and Supplies Billing Guide, July 1, 2022 to September 30, 2022 Medical Equipment and Supplies Billing Guide, View all Medical equipment and supplies billing guides, October 1, 2022 to present Medical Equipment and Supplies fee schedule, July 1, 2022 to September 30, 2022 Medical Equipment and Supplies fee schedule, January 1, 2022 to June 30, 2022 Medical Equipment and Supplies fee schedule, View all medical equipment and supplies fee schedules, August 1, 2022 to present Medical nutrition therapy billing guide, July 1, 2022 to July 31, 2022 Medical nutrition therapy billing guide, October 1, 2020 to June 30, 2022 Medical nutrition therapy billing guide, View all medical nutrition therapy billing guides, July 1, 2022 to present Medical nutrition therapy fee schedule, July 1, 2021 to June 30, 2022 Medical nutrition therapy fee schedule, July 1, 2020 to June 30, 2021 Medical nutrition therapy fee schedule, View all medical nutrition therapy fee schedules, October 1, 2022 to present Mental health services billing guide, August 1, 2022 to September 30, 2022 Mental health services billing guide, July 1, 2022 to July 31, 2022 Mental health services billing guide, View all mental health services billing guides, July 1, 2022 to present Mental health and psychology services fee schedule, January 1, 2022 to June 30, 2022 Mental health and psychology services fee schedule, October 1, 2021 to December 31, 2021 Mental health and psychology services fee schedule, View all mental health services fee schedules, July 1, 2022 to present Specialized mental health fee schedule, January 1, 2022 to June 30, 2022 Specialized mental health fee schedule, October 1, 2021 to December 31, 2021 Specialized mental health fee schedule, View all specialized mental health services fee schedules. 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