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

Sep 28, 2020

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.