Individuals enrolled in Apple Health (Medicaid), Public Employees Benefits Board, and School Employees Benefits Board coverage - and those accessing behavioral health services - will not experience a disruption in care due to the federal government shutdown. In addition, health care providers will continue to be paid for the services they provide. We will continue to monitor the situation closely and share updates if anything changes.
Find billing resources and evaluation and reporting tools for managed care organizations (MCOs), behavioral health – administrative service organizations (BH-ASOs), and fee-for-service (FFS) providers.
Are you interested in providing behavioral health services to residents of Washington through Apple Health (Medicaid)?
All behavioral health services are covered by:
The Global Appraisal of Individual Needs Short Screener (GAIN-SS) is a brief 10-minute instrument designed to quickly and accurately screen general populations of both adults and adolescents for psychiatric disorders, substance use disorders, or crime and violence problems. A result of moderate to high problem severity in any single area or overall suggests the need for further assessment.
The BHDS incorporates integrated behavioral health and substance abuse data, storage, and supporting reporting functions. It also includes data from two legacy systems:
The data guide contains reporting requirements for managed care organizations (MCOs) and behavioral health-administrative services organizations (BH-ASOs) to meet state and federal reporting requirements related to funding.
Online reporting system (Minerva)
The Health Care Authority (HCA) was tasked with the development of a statewide Behavioral Health Service Directory that would include a comprehensive list of behavioral health services throughout Washington state.
HCA contracted with a consultant, Berry Dunn, who developed a guide that reflects current information on the service modalities, facilities, and providers that make up Washington's community behavioral health delivery system.
Every month, HCA hosts a listening session for behavioral health providers to provide program updates.
There have been several legislatively mandated rate increases that affect behavioral health providers in 2023. Read an FAQ about these funding and rate increases to learn more.
The Health Care Authority (HCA) partners with the Social and Economic Sciences Research Center (SESRC) at Washington State University to conduct yearly surveys for behavioral health providers and enrollees.
This survey is an opportunity for BH treatment agencies to let us know about their agency, the improvement efforts they are currently undertaking, and the diversity of their behavioral health clinical staff.
Who is invited to participate in the survey?
HCA, in partnership with our contract actuaries at Milliman, is working on a project to develop comparison rates for behavioral health services. These rates are intended to estimate the actual provider cost of delivering specific behavioral health services and serve as a transparent benchmark to compare current payment levels to. This work is limited to Medicaid services covered under Section 13(d) of the Washington Medicaid State Plan.
The project consists of multiple phases:
HCA and Milliman are releasing a provider cost and wage survey to gather specific information and feedback from a wide range of providers. The information you and other providers submit through the survey, along with other data sources, will be used to refine the comparison rates developed in phase 1 and 2 of this project, as well as inform rates for services not previously covered. Your input will provide important insights into behavioral health provider costs and wage.
The survey is open from November 4 through January 17.
Providers delivering services under Section 13d Rehabilitative Services of Washington’s Medicaid State Plan. These include mental health and substance use disorder outpatient providers, substance use disorder and mental health residential providers, and WISe and PACT service providers. For purposes of this survey, the term “provider” refers to an individual or entity engaged in the delivery, ordering, or referring of the above-mentioned services.
Watch an instructional video for a detailed walk through on how to complete the survey or read frequently asked questions.