Health Care Authority (HCA) coverage for telehealth services

Dental Medicaid

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Health Care Authority (HCA) coverage for telehealth services

Health Care Authority (HCA) coverage for telehealth services

HCA reimburses providers for telemedicine services as related to RCW 74.09.325
Telehealth/telemedicine services provide an important and rapidly evolving suite of access tools for providers and patients for medical, dental and behavioral health services. The Washington Department of Health (DOH) and the Centers for Disease Control (CDC) are referencing the potential use of these tools as part of the state and national response required by the current coronavirus situation.

This document provides information about how to find policies and guidance for billing for telehealth services. It does not provide advice on how to deliver or receive health care or provide medical advice.

An example of a covered telemedicine service includes:

A client/patient calls a provider’s office to request an appointment due to respiratory symptoms and a fever. Instead of making an initial in-person appointment, the provider’s office could set up an appointment with the provider via telemedicine with the client at home. This is an eligible service and the provider could bill for reimbursement of the services.

Medicaid Transition to Managed Care Cancelled

The 2019 Legislature has directed the Washington State Health Care Authority (HCA) to continue to administer the dental Medicaid program through fee-for-service. The HCA may not proceed with a carved-out or carved-in managed care dental option at this time.

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