MedicaidBilling CodesHigh impact
Outpatient Rehabilitation Billing Guide Update, effective July 10, 2026
Washington Apple Health·WA · Physical Therapy, Occupational Therapy, Speech Therapy +1 more·Billing Guide
Effective date
Jul 10, 2026
We identified it
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.
Action Required
By July 31, 2026: Billing 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. Review claims submitted since July 10, 2026, for any with incorrect place of service codes and resubmit as needed. Update billing software templates, claim submission rules, and provider encounter forms to reflect the corrected place of service code descriptions. Incorrect place of service codes may result in claim denials or rejections by Apple Health (Medicaid). Coordinate with providers to verify documentation matches the place of service code being billed.