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Chapter 182-531 WAC

PHYSICIAN-RELATED SERVICES

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Last update: 8/17/26

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WAC 182-531 CHAPTER
WAC Sections
HTMLPDF182-531-0050Physician-related services definitions.
HTMLPDF182-531-0100Scope of coverage for physician-related and health care professional services—General and administrative.
HTMLPDF182-531-0150Noncovered physician-related and health care professional services—General and administrative.
HTMLPDF182-531-0200Physician-related and health care professional services requiring prior authorization.
HTMLPDF182-531-0250Who can provide and bill for physician-related and health care professional services.
HTMLPDF182-531-0300Anesthesia providers and covered physician-related services.
HTMLPDF182-531-0350Anesthesia services—Reimbursement for physician-related services.
HTMLPDF182-531-0375Audiology services.
HTMLPDF182-531-0400Client responsibility for reimbursement for physician-related services.
HTMLPDF182-531-0425Collaborative care.
HTMLPDF182-531-0450Critical care—Physician-related services.
HTMLPDF182-531-0500Emergency physician-related services.
HTMLPDF182-531-0550Experimental and investigational services.
HTMLPDF182-531-0600HIV/AIDS counseling and testing as physician-related services.
HTMLPDF182-531-0650Hospital physician-related services not requiring authorization when provided in agency-approved centers of excellence or hospitals authorized to provide the specific services.
HTMLPDF182-531-0700Inpatient chronic pain management physician-related services.
HTMLPDF182-531-0750Physician-related services provided in a hospital inpatient observation setting.
HTMLPDF182-531-0800Laboratory and pathology services.
HTMLPDF182-531-0850Laboratory and pathology physician-related services reimbursement.
HTMLPDF182-531-0900Neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) physician-related services.
HTMLPDF182-531-0950Office and other outpatient physician-related services.
HTMLPDF182-531-1000Ophthalmic services.
HTMLPDF182-531-1050Osteopathic manipulative therapy.
HTMLPDF182-531-1100Out-of-state physician services.
HTMLPDF182-531-1150Care plan oversight services.
HTMLPDF182-531-1200Physician office medical supplies.
HTMLPDF182-531-1300Foot care services for clients 21 years of age and older.
HTMLPDF182-531-1350Prolonged physician-related services.
HTMLPDF182-531-1400Psychiatric physician-related services and other professional mental health services.
HTMLPDF182-531-1450Radiology physician-related services.
HTMLPDF182-531-1500Sleep studies.
HTMLPDF182-531-1550Sterilization physician-related services.
HTMLPDF182-531-1600Bariatric surgery.
HTMLPDF182-531-1625Outpatient hemophilia treatment requirements—Center of excellence.
HTMLPDF182-531-1650Withdrawal management physician-related services.
HTMLPDF182-531-1675Washington apple health—Gender affirming interventions for gender dysphoria.
HTMLPDF182-531-1700Surgical physician-related services.
HTMLPDF182-531-1710Screening, brief intervention, and referral to treatment (SBIRT).
HTMLPDF182-531-1720Tobacco/nicotine cessation counseling.
HTMLPDF182-531-1740Treat and refer services.
HTMLPDF182-531-1750Transplant coverage for physician-related services.
HTMLPDF182-531-1800Transplant coverage—Medical criteria to receive transplants.
HTMLPDF182-531-1850Payment methodology for physician-related services—General and billing modifiers.
HTMLPDF182-531-1900Payment—General requirements for physician-related services.
HTMLPDF182-531-2000Increased payments for physician-related services for qualified trauma cases.
HTMLPDF182-531-2010Enhanced reimbursement—Independent advanced registered nurse practitioners (ARNPs).
HTMLPDF182-531-2020Enhanced reimbursement—Long-acting reversible contraception (LARC).
HTMLPDF182-531-2030Enhanced rates for pediatric care services and administration of vaccines.
HTMLPDF182-531-2040Enhanced reimbursement—Medication for opioid use disorder.