Health and Recovery Services Administration, Department of Social and Health Services

Prescription Drug Program
Billing Instructions

 


ProviderOne Edition Coming Soon

 

 

30-Day Pre-Release Billing Instructions

N/A
 

Current Billing Instructions (.pdf)
(Use for dates of service on and after July 1, 2009)

 

What Does the Law Say?

 

Where Can I Find Previous Versions of the Billing Instructions

Click on one of the following:

Expedited Authorization (EA) Lists

Washington Preferred Drug Lists (PDL)

Related Memoranda  

Note: Hover your mouse pointer over the memo number to see the subject of that particular # memo.

 

2009 

 

2008

 

2007

 

2006

 

2005

 

2004

 

2003

Notes

  1. On 9/1/05, HRSA did not include Razadyne ER® on page N.3, when issuing # Memo 05-83 MAA.  This was fixed on 10/17/05.

  2. 05-83 was corrected by DC-2005-12.

  3. 05-125 was corrected by DC-2006-1.

  4. 06-07 was originally published 2/17/2006, republished 2/24/2006.  You do not need to rebill.

  5. 12/29/06 - HRSA made an on-line update to memo 06-91.  Amerge®, Axert®, Frova®, and Maxalt MLT® were moved from "Preferred" to "Non-preferred" effective January 1, 2007.  This was reflected in the memorandum, but page replacement N.13 to the Prescription Drug Program Billing Instructions had these four drugs under both the "Preferred" and "Non-preferred" headings.  This typographical error has been corrected.

  6. 11/14/06 - HRSA made an on-line update to memo 06-75.  Seroquel® tablet (quetiapine) was added to the Washington Preferred Drug List on page N.1 of the Prescription Drug Program Billing Instructions.  The current billing instructions have also been updated to reflect this change.  This on-line change will be referenced in the upcoming December memorandum.

  7. 4/11/2007: Corrected a publication error in which 3 drugs were not on the EPA Criteria and Coding List in section H of the Prescription Drug Program Billing Instructions.  These 3 drugs were:  Dolophine, MS Contin, and Opana ER.

  8. 10/22/2007: Fixed a publication error on page N.13 of the billing instructions.  The list of brand name non-preferred drugs in the Targeted Immune Modulator drug class was fixed.

  9. 4/23/2008: Fixed a publication error that affected pages M.15 and M.16 of the billing instructions.  The list of non-preferred brand statin-type cholesterol-lowering agents was inadvertently replaced by the list of non-preferred brand skeletal muscle relaxants.   The list of non-preferred brand skeletal muscle relaxants was fixed as well.  This was a copy and paste error, not a change in policy.  

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