Billing for Opioid Reversal Medication for Uninsured Patients

September 9, 2022

The Washington Health Care Authority has provided a form and billing instructions for hospitals and behavioral health facilities to be reimbursed for opioid reversal medication provided to uninsured patients as a result of Substitute Senate Bill 5195. WSHA worked with legislators and the HCA to ensure hospitals could be reimbursed for the cost of the medication. These expenses can be billed retroactively for medications provided on or after January 1, 2022. For more information see HCA’s recent communication.
Opioid reversal medication provided to Apple Health enrollees should be billed to HCA or the appropriate Medicaid managed care organization through the regular claims submission method for Medicaid claims. Additional billing information is here. (Andrew Busz, AndrewB@wsha.org)

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