INTERPRETIVE OR POLICY STATEMENT
SOCIAL AND HEALTH SERVICES
Subject: Termination of the twenty-four hour rule, HCPCS code usage and guidelines, OPPS implementation, fee schedule changes, and revenue code grid updates.
Effective Date: October 22, 2004.
Document Description: Effective for dates of service on and after November 1, 2004, the Medical Assistance Administration (MAA) will:
• Terminate the twenty-four hour rule; and
• Implement the outpatient prospective payment system (OPPS).
This memorandum also includes:
• Billing guidelines;
• A new OPPS fee schedule;
• A revised outpatient hospital fee schedule for the outpatient hospital billing instructions;
• A revised revenue code grid; and
• A revised definitions section for the outpatient hospital billing instructions.
To receive a copy of the interpretive or policy statement, contact Barbara Salmon, Rules and Publications Section, Department of Social and Health Services, Medical Assistance Administration, Division of Policy and Analysis, P.O. Box 45533, Olympia, WA 98504-5533, phone (360) 725-1349 or go to website http://maa.dshs.wa.gov/download/publicationsfees.htm (click on "Numbered Memos," "Year 2003"), TDD 1-800-848-5429, fax (360) 586-9727, e-mail salmobl@dshs.wa.gov.
October 26, 2004
Ann Myers, Manager
Rules and Publications Section