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MedicaidBilling CodesMedium impact

Urological and incontinent supplies new billing codes, effective January 1, 2026

Washington Apple Health·WA · Urology·Provider Alert
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Washington State Medicaid added three new HCPCS codes (A4295, A4296, A4297) specifically for hydrophilic-coated urological catheters, effective retroactively from January 1, 2026. Providers must rebill any claims submitted with the old codes (A4351, A4352, A4353) for hydrophilic catheters using the new specific codes once the system is updated on April 1, 2026.

Action Required

Action needed
By April 1, 2026: Billing team must update coding system to use new HCPCS codes A4295, A4296, and A4297 for hydrophilic-coated catheters instead of A4351, A4352, and A4353. Rebill any claims with dates of service on or after January 1, 2026 that used the old codes for hydrophilic catheters. Update billing rules to enforce 180 unit per month maximum and code combination restrictions.

Affected Billing Codes

A4295
A4296
A4297
A4351
A4352
A4353
A4354