HCA Releases Details on Legislatively Funded Medicaid Provider Rate Increases.

August 16, 2023

The Washington State Health Care Authority (HCA) recently released an overview, table, and FAQs regarding legislatively mandated Medicaid provider rate increases authorized in the 2023-25 state operating budget effective January 1, 2024. The specific service, provider, and contract terms will determine whether the increases will directly translate to increased payments through the Medicaid managed care organizations. The increases will be reflected in HCA’s published Medicaid fee schedules that will be published around the effective date. In the meantime, hospitals and providers of these specific services may wish to use this information to estimate the potential financial impact for their organizations.

The document addresses the following rate increases:

  • Applied behavior analysis (ABA) rates
  • Behavioral health provider rates (lower-level, non-behavioral health agency)
  • Developmental screening rates
  • Home and birthing center rates
  • Kidney dialysis rates
  • Pediatric palliative care rates
  • Newborn screening fee
  • MCO behavioral health rate (behavioral health agency – non-hospital)

The legislature also authorized increases to primary care and other specific professional services effective January 1, 2025. More information on those increases will be provided closer to the effective date. (Andrew Busz, andrewb@wsha.org)


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