Reminder: Hospital trauma services enhanced professional payments

Immediately: Billing team must implement system logic to ensure the ST modifier is added to all qualifying trauma service claims submitted to Washington State Apple Health (Medicaid). Providers must document trauma cases and ensure the ST modifier is included on initial claim submission to maximize reimbursement at 275% of the base rate. Train all billing and coding staff on proper use of the ST modifier for trauma services. Update billing software templates and encounter forms to prompt for ST modifier selection when trauma diagnoses are identified. Note: Lab and pathology services are NOT eligible for trauma enhancement and should NOT receive the ST modifier. For claims submitted without the ST modifier, submit adjustment requests within 1 year of the original service date to add the modifier and receive the enhanced payment retroactively. Failure to apply the ST modifier will result in payment at standard rates instead of the enhanced 275% rate.