(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.]