On June 26th, the Health Care Authority (HCA) sent a follow up communication to providers regarding which ABA providers must enroll with Apple Health (Medicaid) and which individual providers must be identified as servicing providers on ABA claims. All ABA providers, including but not limited to Licensed Behavior Analysts (LBAs), Licensed Assistant Behavior Analysts (LABAs) and CBTs must enroll as servicing/rendering providers so their NPIs may be listed on claims for services they provide (see WAC 182-502-0005(2)).
Effective July 1, 2024, all CBTs and LABAs working with Apple Health clients must meet the following requirements:
- Have an active CBT or LABA license with DOH
- Have an NPI
- Enroll with the HCA Provider Enrollment as a servicing/rendering provider or non-billing provider under a group’s Core Provider Agreement (CPA).
- Enroll with the MCO as a servicing/rendering provider.
- For dates of service on or after July 1, 2024, all CBTs, LABAs, and LBAs have their NPIs captured on claims as the servicing/rendering provider for services they perform.
For CHPW to comply with this requirement and configure servicing providers in our system for claims payment, we request ABA entities provide a roster which will allow servicing providers to be loaded into our system. A template roster is attached to this email; CHPW is requesting a completed roster be submitted as soon as possible, no later than May 10th, 2024.
Submit roster via email to: [email protected]
Are your NPIs registered with HCA?
ALL required NPIs billed on a claim form for in-network providers must be registered with HCA in order to receive payment. These include the group billing NPI and the individual practitioner’s rendering or servicing NPI.
Register your NPIs,
http://www.hca.wa.gov/billers-providers/apple-health-medicaid-providers/enroll-provider.
Revalidate your NPIs,
https://www.hca.wa.gov/billers-providers-partners/become-apple-health-provider/revalidation.
As always, our goal is to provide you with excellent customer service. We will continue our commitment to provide high quality support and services to our provider network.
If you have any questions or concerns, please email [email protected]
