Wash. Admin. Code § 182-540-170 – Items and services not included in the composite rate

The following items and services are not included in the composite rate and must be billed separately, subject to the restrictions or limitations in this section and other applicable published WAC:

(1) Drugs related to treatment including, but not limited to, epoetin alpha (EPO) and diazepam. The drug must:
1. (a) Be prescribed by a physician;
2. (b) Meet the rebate requirements described in WAC 182-530-7500; and
3. (c) Meet the requirements of WAC 246-945-090 when provided for home use.
(2) Supplies used to administer drugs and blood;
(3) Blood processing fees charged by the blood bank (refer to WAC 182-540-190); and
(4) Home dialysis helpers.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 25-09-050, s 182-540-170, filed 4/10/25, effective 5/11/25; WSR 15-14-040, § 182-540-170, filed 6/24/15, effective 7/25/15. WSR 11-14-075, recodified as § 182-540-170, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.510, 74.09.520, 74.09.522, and 42 C.F.R. 405.2101. WSR 03-21-039, § 388-540-170, filed 10/8/03, effective 11/8/03.]