MedicaidBilling CodesMedium impact
Revised policies for COVID-19 for billing POS 10
Washington Apple Health·WA · Physical Therapy, Occupational Therapy, Endocrinology +1 more·Provider Alert
Effective date
Jul 22, 2022
We identified it
Jun 20, 2026
Summary
Effective July 22, 2022, Washington State Apple Health (Medicaid) requires adding modifier 95 to claims when billing place of service (POS) 10 if the distant site is designated as a nonfacility. This ensures nonfacility providers receive appropriate nonfacility payment rates for telehealth services.
Action Required
By July 22, 2022: Billing team must update billing system to automatically append modifier 95 to all Apple Health (Medicaid) claims when using place of service code 10 and the distant site is designated as nonfacility. Update telehealth billing procedures for ABA therapy, clinical services, diabetes education, and physical/occupational/speech therapy. Failure to add modifier 95 may result in incorrect facility payment rates instead of higher nonfacility rates.