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Washington Apple HealthMedicaid · Billing Codes · Billing Guide · WA · Physical Therapy, Occupational Therapy, Speech Therapy +1 moreHigh impact

Outpatient Rehabilitation Billing Guide Update, effective July 10, 2026

Act
by Jul 31, 2026
Effective date
Jul 10, 2026
Identified
Jul 15, 2026

Summary

Washington State HCA corrected an error in the Outpatient Rehabilitation Billing Guide by updating place of service code descriptions: Office procedures now use place of service code 11, and Home-based services now use place of service code 12. Billing teams must verify these codes are correctly mapped in their systems to ensure claim processing accuracy.

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What to do

by Jul 31, 2026 · 5 steps
01Billing team must audit and update all outpatient rehabilitation billing records and system configurations to ensure place of service codes are correctly assigned—code 11 for Office visits and code 12 for Home-based services.
02Review claims submitted since July 10, 2026, for any with incorrect place of service codes and resubmit as needed.
03Update billing software templates, claim submission rules, and provider encounter forms to reflect the corrected place of service code descriptions.
04Incorrect place of service codes may result in claim denials or rejections by Apple Health (Medicaid).
05Coordinate with providers to verify documentation matches the place of service code being billed.

Original notice

Outpatient Rehabilitation Billing Guide Update, effective July 10, 2026
content.govdelivery.com · Always check the source before changing claims.
View original ↗

Related policy hubs

Washington Apple Health policiesWA policy changesPhysical TherapyOccupational TherapySpeech TherapyPM&R (Physical Medicine & Rehab)

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