Quarterly Billing Guide Updates, Effective 7/1/2026

By June 30, 2026: Billing team must access and review the updated Apple Health billing guides on the HCA Provider billing guides and fee schedules webpage for your program(s). Specifically identify and document all changes to vaccine/toxoid (immunization) coverage policies, billing codes, and any associated documentation or prior authorization requirements. Update billing system rules, encounter forms, and provider guidance documents to reflect new immunization coverage policies before the July 1, 2026 effective date. Communicate changes to clinical staff and providers. For specific code and coverage questions not clarified in the updated guides, email hcaapplehealthclinicalpolicy@hca.wa.gov. Failure to implement these changes may result in claim denials for immunization services billed under outdated coverage policies.