New Apple Health policy covers postpartum days when newborn confined due to possible substance dependence

October 6, 2022

Effective October 1, 2022, HCA implemented a policy that in certain cases, will enable hospitals to receive payment for up to five days for the continued hospital stay of a postpartum parent. The policy applies in cases where a newborn remains inpatient due to in utero exposure to a substance that may lead to physiologic dependence and may require non-pharmacologic treatment. The policy applies to Apple Health enrollees under both fee for service and managed care. WSHA supported both the clinical policy and the provision of payment for these additional days, which previously had not been reimbursed. The policy helps ensure continuity of care for the birthing parent and the newborn.

Per WAC 182-550-4550, HCA will cover up to five days of an inpatient hospital stay for the postpartum parent following the parent’s medical discharge when the newborn remains as an inpatient on a hospital claim at the facility and meets specified criteria. As is the case for other administrative day payments, the additional days should be billed as a separate billing from the acute inpatient stay for the delivery.  For billing information and criteria, see page 90 of the Inpatient Hospital Services Billing Guide. (Andrew Busz,


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