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Washington Administrative Code (WAC)

Chapter 531

Wash. Admin. Code ch. 182-531

Physician-related Services

HEALTH CARE AUTHORITY

182-531-0050Physician-related services definitions 182-531-0100Scope of coverage for physician-related and health care professional services—General and administrative 182-531-0150Noncovered physician-related and health care professional services—General and administrative 182-531-0200Physician-related and health care professional services requiring prior authorization 182-531-0250Who can provide and bill for physician-related and health care professional services 182-531-0300Anesthesia providers and covered physician-related services 182-531-0350Anesthesia services—Reimbursement for physician-related services 182-531-0375Audiology services 182-531-0400Client responsibility for reimbursement for physician-related services 182-531-0425Collaborative care 182-531-0450Critical care—Physician-related services 182-531-0500Emergency physician-related services 182-531-0550Experimental and investigational services 182-531-0600HIV/AIDS counseling and testing as physician-related services 182-531-0650Hospital physician-related services not requiring authorization when provided in agency-approved centers of excellence or hospitals authorized to provide the specific services 182-531-0700Inpatient chronic pain management physician-related services 182-531-0750Inpatient hospital physician-related services 182-531-0800Laboratory and pathology physician-related services 182-531-0850Laboratory and pathology physician-related services reimbursement 182-531-0900Neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) physician-related services 182-531-0950Office and other outpatient physician-related services 182-531-1000Ophthalmic services 182-531-1050Manipulative therapy 182-531-1100Out-of-state physician services 182-531-1150Care plan oversight services 182-531-1200Physician office medical supplies 182-531-1300Foot care services for clients 21 years of age and older 182-531-1350Prolonged physician-related services 182-531-1400Psychiatric physician-related services and other professional mental health services 182-531-1450Radiology physician-related services 182-531-1500Sleep studies 182-531-1550Sterilization physician-related services 182-531-1600Bariatric surgery 182-531-1625Outpatient hemophilia treatment requirements—Center of excellence 182-531-1650Substance abuse detoxification physician-related services 182-531-1675Washington apple health—Gender affirming interventions for gender dysphoria 182-531-1700Surgical physician-related services 182-531-1710Screening, brief intervention, and referral to treatment (SBIRT)182-531-1720Tobacco/nicotine cessation counseling 182-531-1740Treat and refer services 182-531-1750Transplant coverage for physician-related services 182-531-1800Transplant coverage—Medical criteria to receive transplants 182-531-1850Payment methodology for physician-related services—General and billing modifiers 182-531-1900Payment—General requirements for physician-related services 182-531-2000Increased payments for physician-related services for qualified trauma cases 182-531-2010Enhanced reimbursement—Independent advanced registered nurse practitioners (ARNPs)182-531-2020Enhanced reimbursement—Long-acting reversible contraception (LARC)182-531-2030Enhanced rates for pediatric care services and administration of vaccines 182-531-2040Enhanced reimbursement—Medication for opioid use disorder