MedicaidCoverageMedium impact
COVID-19 testing—Molecular and antigen updates eff. 10/1/2026
Washington Apple Health·WA · Infectious Disease, Emergency Medicine, Internal Medicine +1 more·Provider Alert
Effective date
Oct 1, 2026
We identified it
Jul 1, 2026
Summary
The Washington State Health Care Authority (HCA) has updated the COVID-19 molecular and antigen testing section of the Physician-Related Services/Health Care Professional Services Billing Guide effective October 1, 2026, with added information on client immunodeficiency. Billing teams must review the updated guide to identify specific changes to testing codes and policies, particularly related to immunodeficient patients.
Action Required
By September 15, 2026: Billing team must access the HCA Provider billing guides and fee schedules webpage to review the complete updated COVID-19 testing guide and the 'What has changed' table. Identify all affected CPT/HCPCS codes and immunodeficiency-related billing requirements. Update billing software, encounter forms, and staff training materials to reflect new testing policies. Contact HCA if clarification is needed on specific coding changes. Failure to implement updates by the October 1, 2026 effective date may result in claim denials for COVID-19 testing services.