Statutes, codes, and regulations
Washington Administrative Code
Title 182 - Health Care AuthorityWASHINGTON APPLE HEALTH
Chapter 182-537 - School-based health care services
Section 182-537-0600 - School district requirements for billing and payment

Wash. Admin. Code § 182-537-0600

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Current through Register Vol. 24-21, November 1, 2024
Section 182-537-0600 - School district requirements for billing and payment

To receive payment from the medicaid agency for providing school-based health care services (SBHS) to eligible children, a school district must:

(1) Enroll as a billing provider in Provider One and have a current, signed core provider agreement (CPA) with the agency.
(2) Have a current, signed, and executed SBHS contract with the agency.
(3) Meet the applicable requirements in chapter 182-502 WAC.
(4) Comply with the applicable requirements in the agency's current, published Provider One billing and resource guide.
(5) Bill according to the agency's current SBHS billing guide and the SBHS fee schedule.
(6) Provide only early intervention or health care-related services identified through a current individualized education program (IEP) or individualized family service plan (IFSP).
(7) Use only licensed health care providers or nonlicensed people practicing under the supervision of a licensed provider under WAC 182-537-0350.
(8) Enroll licensed health care providers as servicing providers under the school district's Provider One account, and ensure providers have their own national provider identifier (NPI) number.
(9) Meet documentation requirements described in WAC 182-537-0700.

Wash. Admin. Code § 182-537-0600

Amended by WSR 16-07-141, Filed 3/23/2016, effective 4/23/2016
Amended by WSR 19-04-095, Filed 2/5/2019, effective 3/8/2019
Amended by WSR 20-14-062, Filed 6/26/2020, effective 7/27/2020
Amended by WSR 22-14-019, Filed 6/24/2022, effective 8/1/2022
Statutory Authority: RCW 41.05.021, 34 C.F.R. 300.154(d), and chapter 182-502 WAC. WSR 13-21-079, §182-537-0600, filed 10/17/13, effective 11/17/13. Statutory Authority: RCW 41.05.021. WSR 13-05-017, §182-537-0600, filed 2/7/13, effective 3/10/13. WSR 11-14-075, recodified as §182-537-0600, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.500, and 42 C.F.R. 440.110. WSR 09-07-004, § 388-537-0600, filed 3/4/09, effective 4/4/09. WSR 13-21-003, §182-537-0600, filed 10/3/2013, effective 11/3/2013