Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-531 - Physician-related services
Section 182-531-1900 - Payment-General requirements for physician-related services
Current through Register Vol. 24-18, September 15, 2024
(1) The medicaid agency pays physicians and related providers for covered services provided to eligible clients on a fee-for-service basis, subject to the exceptions, restrictions, and other limitations listed in this chapter and other published issuances.
(2) To receive payment, physicians must bill the agency according to the conditions of payment under WAC 182-502-0100.
(3) The agency does not separately reimburse certain administrative costs or services. The agency considers these costs to be included in the payment. These costs and services include the following:
(4) The agency does not routinely pay for procedure codes which have a "#" or "NC" indicator in the fee schedule. The agency reviews these codes for conformance to medicaid program policy only as an exception to policy or as a limitation extension. See WAC 182-501-0160 and 182-501-0165.
11-14-075, recodified as §182-531-1900, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090. 10-19-057, § 388-531-1900, filed 9/14/10, effective 10/15/10. Statutory Authority: RCW 74.08.090, 74.09.520. 01-01-012, § 388-531-1900, filed 12/6/00, effective 1/6/01.
