Filetype Excel XLSX | Posted on 08 Aug 2022 | 3 years ago
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175x Filetype XLSX File size 0.02 MB Source: www.hca.wa.gov
Washington State Health Care Authority (HCA)
Emergency Covid-19 Fee Schedule
Please see effective dates of each code
Rate changes effective on, or before, July 1, 2022
Updated 7/28/22
Code
Status Maximum Maximum Code Coverage
Indicator Code Mod Allowable NFS Fee Allowable FS Fee PA Required Effective Date
0001A $40.00 $40.00 12/11/2020
0002A $40.00 $40.00 12/11/2020
0003A $40.00 $40.00 8/12/2021
0004A $40.00 $40.00 9/22/2021
0011A $40.00 $40.00 12/18/2020
0012A $40.00 $40.00 12/18/2020
0013A $40.00 $40.00 8/12/2021
0031A $40.00 $40.00 2/27/2021
0034A $40.00 $40.00 10/20/2021
N 0041A $40.00 $40.00 7/13/2022
N 0042A $40.00 $40.00 7/13/2022
0051A $40.00 $40.00 10/29/2021
0052A $40.00 $40.00 10/29/2021
0053A $40.00 $40.00 10/29/2021
0054A $40.00 $40.00 10/29/2021
0064A $40.00 $40.00 10/20/2021
0071A $40.00 $40.00 10/29/2021
0072A $40.00 $40.00 10/29/2021
0073A $40.00 $40.00 1/3/2022
0074A $40.00 $40.00 5/17/2022
N 0081A $40.00 $40.00 6/17/2022
N 0082A $40.00 $40.00 6/17/2022
N 0083A $40.00 $40.00 6/17/2022
N 0091A $40.00 $40.00 6/17/2022
N 0092A $40.00 $40.00 6/17/2022
N 0093A $40.00 $40.00 6/17/2022
0094A $40.00 $40.00 3/29/2022
N 0111A $40.00 $40.00 6/17/2022
N 0112A $40.00 $40.00 6/17/2022
N 0113A $40.00 $40.00 6/17/2022
0202U NC NC
0223U NC NC
0224U NC NC
R/L 86328 CR $41.20 $41.20 4/10/2020
L 86408 CR $41.96 $41.96 8/10/2020
L 86409 CR $79.29 $79.29 8/10/2020
L 86413 CR $51.22 $51.22 9/8/2020
R/L 86769 CR $38.34 $38.34 4/10/2020
L 87426 CR $35.19 $35.19 6/25/2020
R/L 87428 CR $28.16 $28.16 11/10/2020
R/L 87635 CR $46.69 $46.69 3/13/2020
R/L 87636 CR $129.80 $129.80 10/6/2020
R/L 87637 CR $129.80 $129.80 10/6/2020
L 87811 CR $41.21 $41.21 10/6/2020
L 87913 CR BR BR 2/21/2022
91300 CR $0.00 $0.00 12/11/2020
91301 CR $0.00 $0.00 12/18/2020
91303 CR $0.00 $0.00 2/27/2021
N 91304 CR $0.00 $0.00 7/13/2022
91305 CR $0.00 $0.00 10/29/2021
91306 CR $0.00 $0.00 10/20/2021
91307 CR $0.00 $0.00 10/29/2021
N 91308 CR $0.00 $0.00 6/17/2022
91309 CR $0.00 $0.00 3/29/2022
N 91311 CR $0.00 $0.00 6/17/2022
98966 CR $20.00 $20.00 4/1/2020
98967 CR $30.00 $30.00 4/1/2020
98968 CR $40.00 $40.00 4/1/2020
99001 CR NC NC 1/1/2020
99050 CR $10.00 $10.00 4/24/2020
99051 CR $5.00 $5.00 4/24/2020
99072 CR NC NC 9/8/2020
continuously
99211 see comment see comment covered
continuously
99212 see comment see comment covered
continuously
99213 see comment see comment covered
continuously
99214 see comment see comment covered
continuously
99215 see comment see comment covered
continuously
99401 see comment see comment covered
R 99421 CR $8.74 $7.38 1/1/2020
R 99422 CR $17.09 $14.76 1/1/2020
R 99423 CR $27.77 $23.69 1/1/2020
99429 CR $27.58 $27.58 4/1/2020
99441 CR see comment see comment 1/1/2020
99442 CR see comment see comment 1/1/2020
99443 CR see comment see comment 1/1/2020
R 99451 CR $20.59 $20.59 3/27/2020
99600 CR $12.00 $12.00 1/1/2020
C9507 CR NA NA 12/28/2021
C9803 CR NA NA 3/1/2020
D0170 $10.00 $10.00 4/22/2020
D0415 $21.49 $21.49 1/1/2021
D0604 $8.39 $8.39 1/1/2021
R G2012 CR $8.35 $7.19 1/1/2020
R G2023 CR $21.35 $21.35 3/1/2020
R G2024 CR $23.17 $23.17 3/1/2020
R J0248 CR $5.51 $5.51 12/23/2021
M0201 $35.00 $35.00 8/12/2021
R M0220 $88.65 $88.65 12/8/2021
R M0221 $147.58 $147.58 12/8/2021
R M0222 $206.46 $206.46 2/11/2022
R M0223 $324.10 $324.10 2/11/2022
11/10/2020 -
M0239 NC NC 4/15/2021
7/30/2021 -
M0240 NC NC 1/23/22
7/30/2021 -
M0241 NC NC 1/23/22
11/21/2020 -
M0243 NC NC 1/23/22
5/6/2021 -
M0244 NC NC 1/23/22
2/9/2021 -
M0245 NC NC 1/23/22
5/6/2021 -
M0246 NC NC 1/23/22
5/26/2021 -
M0247 NC NC 4/4/22
5/26/2021 -
M0248 NC NC 4/4/22
M0249 NC NC 6/24/2021
M0250 NC NC 6/24/2021
Q0220 $0.00 $0.00 12/8/2021
Q0221 $0.00 $0.00 2/24/2022
Q0222 $0.00 $0.00 2/11/2022
11/10/2020 -
Q0239 NC NC 4/15/2021
7/30/2021 -
Q0240 NC NC 1/23/22
11/21/2020 -
Q0243 NC NC 1/23/22
6/3/2021 -
Q0244 NC NC 1/23/22
2/9/2021 -
Q0245 NC NC 1/23/22
5/26/2021 -
Q0247 NC NC 4/4/22
Q0249 NC NC 6/24/2021
Q3014 CR see comment see comment 3/1/2020
R/L U0001 CR $32.69 $32.69 2/4/2020
R/L U0002 CR $46.69 $46.69 2/4/2020
R/L U0003 CR $68.25 $68.25 4/14/2020
R/L U0004 CR $68.25 $68.25 4/14/2020
U0005 CR NC NC 1/1/2021
Code Status Indicators Modifier Legend
D = Discontinued Code CR - Catastrophe/disaster related FS - Facility Setting
N = New Code NFS - Non-Facility Setting
P = Policy Change B.R - Pays a percentage of billed usual/customary
R = Rate Update NC - Not covered
L = Limitations, see billing guide
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