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MedicaidBilling CodesMedium impact

COVID-19 testing clinical policy updates, effective 2/21/2022

Washington Apple Health·WA · Family Medicine, Internal Medicine, Emergency Medicine·Medical Policy
Effective date
Feb 21, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Washington State updated COVID-19 testing policies for Apple Health (Medicaid) effective February 21, 2022. Key changes include allowing modifier QW for CLIA-waived tests, adding CPT code 87913 to PCR testing, and clarifying that FDA-designated CLIA-waived COVID-19 antibody tests don't require CLIA certification.

Action Required

Action needed
Billing team should update systems to include CPT code 87913 for COVID-19 PCR testing claims. Add modifier QW when billing for CLIA-waived COVID-19 tests if your facility has a Certificate of Waiver. Review COVID-19 antibody test billing to ensure FDA-designated CLIA-waived tests are processed correctly without requiring CLIA laboratory certification.

Affected Billing Codes

87913