Behavioral health and recovery

Apple Health clients have access to behavioral health (mental health and substance use disorder treatment) services, including crisis services, short-term mental health treatment, and inpatient psychiatric services.

Learn more about this program and how to become a behavioral health provider.

Behavioral health covered services

How do providers identify the correct payer?

In most of Washington

Services are covered as follows:

Lower level mental health services are covered by:
- Apple Health managed care plans, or
- Apple Health fee-for-service (FFS) program.
All other mental health and drug and alcohol treatment services are covered by:
- Behavioral Health Organizations (BHOs), or
- Apple Health fee-for-service (FFS) program.

In Southwest Washington(Clark and Skamania) and North Central Washington (Chelan, Douglas, and Grant) regions

All behavioral health services are covered by:

Apple Health Fully Integrated Managed Care plans, or
Apple Health managed care plans under the Behavioral Health Service Only benefit package, or
Apple Health fee-for-service (FFS) program.

Behavioral Health - Primary Care Integration

SSB 5779 passed in the 2017 legislative session.

The purpose of SSB 5779 is to promote efforts towards bi-directional behavioral health and primary care integration. One component of this bill requires the Health Care Authority to review payment codes related to primary care and behavioral health, create, and publish a matrix.

The project has been divided into three phases of code matrix creation. The intention of the matrix is to provide information to providers for successful reimbursement. Each matrix will be posted on the website as they are completed. A proposed implementation plan will be developed by the end of 2017. Please note that there are no changes in coding procedures at this time.