What has changed?
In April 2021, the Washington State Legislature passed 2HB1325. The bill made changes to Apple Health policies regarding mental health assessments for children from birth through age five.
This set of new policies is currently referred to as Mental Health Assesment for Young Children (MHAYC).
The changes include:
- Enhanced reimbursement, including:
- Reimbursement for up to five sessions for assessment, if necessary
- Reimbursement of provider travel costs for assessments conducted in home or community settings
- Requirement to use the DC:0-5™ diagnostic classification system
When is provider travel eligible for reimbursement?
Provider travel is eligible for reimbursement under a specific and limited set of circumstances. The provider must be traveling for:
- The purpose of conducting a mental health assessment (CPT code 90791, 90792 or H0031 ONLY)
- For a child from birth through the age of five (up till their 6th birthday)
- For a session that is conducted in the child/family’s home or in a community setting (POS 03/ School; 04/Homeless Shelter; 12/Home or 99/Other Place of Service ONLY)
How will MHAYC provider travel be reimbursed for providers serving children enrolled with Community Health Plan of WA?
Providers will utilize this form: ➜ MHAYC Provider A-19 Form
To complete the A19, each line/entry must include:
- The Service Date of the diagnostic assessment
- The ProviderOne client ID
- Addresses of starting and ending point
- Miles from starting point to ending point
- Mileage rate (prepopulated on A19)
- Submit invoices to [email protected]
All invoices will be validated to claims per eligibility requirements for reimbursement as outlined here. No invoice will be paid without an adjudicated claim.
Invoices must be submitted no later than 60 days from an adjudicated supporting claim.
More information
Please submit any questions or concerns to [email protected].
Additional information can also be found here:
- RCW 74.09.520
- WA Health Care Authority
