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Individual service codes will be assigned within contract service groupings. Changes to an individual provider’s compensation will depend on the presence or absence of specific service groupings within the contract. The changes are outlined below.
All updates will start on March 1, 2020, unless otherwise noted.
Codes |
Provider types affected |
What’s changing |
J1095, J2186, J2787 |
Facilities including acute short-term hospitals, free-standing ambulatory surgery centers, skilled nursing facilities |
These codes will be added to the following contract service groupings:
|
Q5109, Q5111 |
Facilities including acute short-term hospitals, free-standing ambulatory surgery centers, skilled nursing facilities, infusion facilities, dialysis facilities, physician providers, home health providers
|
These codes will be added to the following contract service groupings:
|
J9022, J9023, J9203, J9285 |
Facilities including acute short-term hospitals, free-standing ambulatory surgery centers, skilled nursing facilities |
These codes will be added to the following contract service groupings:
|
J3591 |
Facilities including acute short-term hospitals, free-standing ambulatory surgery centers, skilled nursing facilities, infusion facilities, dialysis facilities, physician providers, home health providers
|
These codes will be added to the following contract service groupings:
|
J0185, J0517, J0567, J0584, J0599, J0841, J1301, J1454, J1628, J1746, J2062, J2797 J3245, J3304, J3397, J3398, J7170, J7177, J7203, J7318, J7329 Q9991, Q9992, Q5105, Q5106, Q5108, Q5110 |
Facilities including acute short-term hospitals, free-standing ambulatory surgery centers, skilled nursing facilities |
These codes will be removed from the following contract service grouping:
|
This is subject to regulatory review and separate notification in Washington state.
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