HCA: Updated COVID-19 FAQ for Clinical Policy and Billing

Dental Medicaid

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COVID-19: HCA has created a web page ​for COVID-19 information. For Medicaid provider information, scroll down to the "Providers" section.

Latest Medicaid News

HCA: Updated COVID-19 FAQ for Clinical Policy and Billing

The Health Care Authority sent the following alert to dental Medicaid providers.

Apple Health (Medicaid) Provider Alert

Attention provider:

The Health Care Authority (HCA) revised the Apple Health (Medicaid) clinical policy and billing for COVID-19 Frequently Asked Questions.

What changed?

The following changes were made:

  • Clarified billing requirements for providers who usually receive an enhanced rate for services.
  • Added billing for services provided via email to HCPCS code G2012.
  • Expanded the services allowed to be billed with GE modifier to include CPT® codes 99421-23, 99441-43, and HCPCS code G2012.
  • Added CPT code 86413 SARS-CoV2/COVID-19 antibody, quantitative to the list.
  • Ended coverage of CPT code 99001 for drive up/drive through COVID-19 specimen collection, effective 10/15/2020. Added HCPCS codes G2023, G2024, and C9803 to align with Medicare when billing for specimen collection.
  • Added information that aligns with CMS guidance regarding payment for counseling patients at the time of the COVID-19 testing.​

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.

Learn More

Questions? Please email info@wsda.org.