Wash. Admin. Code § 182-531-1150 – Care plan oversight services

(1) The medicaid agency covers care plan oversight services only when:
1. (a) The billing physician or other qualified health care professional (QHCP) follows standard current procedural terminology (CPT) coding guidelines;
2. (b) The client is served by a home health agency, a nursing facility, or a hospice;
3. (c) The facility/agency has established a plan of care; and
4. (d) The physician or QHCP spends 30 or more minutes per calendar month providing oversight for the client's care.
(2) The medicaid agency pays for only one care plan oversight service per client, per month.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 25-18-049, s 182-531-1150, filed 8/27/25, effective 9/27/25. WSR 11-14-075, recodified as § 182-531-1150, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090. WSR 10-19-057, § 388-531-1150, filed 9/14/10, effective 10/15/10. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 01-01-012, § 388-531-1150, filed 12/6/00, effective 1/6/01.]