PDFWAC 182-531-1350
Prolonged physician-related services.
(1) The medicaid agency pays for prolonged services based on established medicare guidelines. The services provided may or may not be continuous. The services provided must meet both of the following:
(a) Consist of face-to-face contact between the physician or qualified health care professional (QHCP) and the client; and
(b) Be provided with other services.
(2) The medicaid agency pays for a prolonged service procedure in addition to an evaluation and management (E&M) procedure or consultation subject to applicable coding limitations and appropriate modifiers.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 25-18-049, s 182-531-1350, filed 8/27/25, effective 9/27/25. WSR 11-14-075, recodified as § 182-531-1350, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090. WSR 10-19-057, § 388-531-1350, filed 9/14/10, effective 10/15/10. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 01-01-012, § 388-531-1350, filed 12/6/00, effective 1/6/01.]