Provider Alerts 2026

Emails relevant to rules, Medicaid provider guides, and policies.

Date Provider Alert
1/8/2026

Updated January 1, 2026 Complex Rehabilitation Technology (CRT) and Prosthetics & Orthotics (P&O) Billing Guides
1/16/2026

Inpatient hospital DRG outlier threshold increase; effective January 1, 2026

1/30/2026

Updated Rural Health Clinics (RHC) Billing Guide
1/30/2026

Updated Prosthetic and Orthotic Devices Billing Guide
2/5/2026

Nursing Facility Held Claims Update
2/13/2026

Updated Maternity Support Services (MSS) Billing Guide, effective February 28, 2026
2/13/2026

Updated Sleep Centers Billing Guide, effective February 13, 2026
3/2/2026

Dental-Related Services Billing Guide update, effective March 14, 2026
3/6/2026 Health-Related Social Needs Billing Guide Updates
3/17/2026

Quarterly Billing Guide Updates, Effective 04/01/2026
3/24/2026

Mental Health Services Billing Guide Updates, effective April 1, 2026
3/25/2026

Family Planning Billing Guide Updates
3/27/2026

Urological and incontinent supplies new billing codes, effective January 1, 2026
4/20/2026

Ambulatory Surgery Center (ASC) providers
4/24/2026

Reentry Billing Guide Update, eff. May 1st 2026
00459: ProviderOne outage planned for Saturday, January 10, 2026
Discovery log number
00459
Discovery description

The ProviderOne system will be unavailable from 4 p.m. until 9 p.m. on Saturday, January 10, 2026 (5 hours) due to scheduled maintenance.

This outage does not affect the Pharmacy POS

Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.

Please report any issues to:  mmishelp@hca.wa.gov.

Thank you.

Date reported
ETA
Provider impact
All Providers
Workaround
Please report any issues to: mmishelp@hca.wa.gov.
Description
The agency is amending its ABLE Act rule to change from 26 to 46 the age by which disability must have begun for purposes of eligibility.

Agency contacts

Rulemaking contact

Brian Jensen

Program contact

Paige Lewis

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

  • WSR 26-05-026
  • Hearing Date: 3/24/2026
  • Registration is required to attend the public hearing.
    View the rulemaking's CR102 for the registration link.
  • Comments Due: 3/24/2026

Permanent Adoption (CR103P)

Description
HCA is creating a new behavioral health rule to implement the requirements of RCW 71.05.110(2) and RCW 71.05.620(2) regarding appointed counsel and access to closed Involuntary Treatment Act court files and records. Newly enacted legislation (ESSB 5745 2025) amended RCW 71.05.110 to provide that, under certain circumstances, HCA may contract with OPD to provide legal counsel for persons involuntarily detained at state-operated behavioral health facilities. OPD also provides appellate counsel in these cases. OPD needs express legal authority granted by HCA rule to timely access court files and records, enter an appearance before the court, and provide legal representation to the detained person.

Agency contacts

Rulemaking contact

Jason Crabbe

Program contact

Annette Schuffenhauer

Rulemaking status history

Preproposal (CR101)

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