May 20, 2021
On April 16, 2021, Washington
Substitute Senate Bill 5169 went into effect mandating that personal protective equipment (PPE) for medical providers be covered as a separate expense for each individual patient encounter.
- This coverage is for in-person medical
provider visits only.
- Claims may be billed
for incurred PPE expenses as a separate expense
up to $6.57 for each individual patient encounter, using the American Medical Association's current procedural terminology code 99072 or as
subsequently amended.
- Note that claims for PPE for patients that are part of a self-funded group will be denied per the bill. Patients may not be billed for provider PPE.
- This bill is not retroactive;
providers may not bill for any PPE costs prior to the effective date and
is limited to the covered service according to the terms and conditions of
the health benefit plan and does not apply to an expense for PPE.
- This bill is now in effect for dates
of service that began April 16, 2021, and will run for the duration of the COVID-19 federal public health emergency.
Review additional details in the Personal Protective Equipment payment
policy