Approved State Directed Payment Preprints

Minimum fee schedule established by the state for durable medical equipment for the rating period covering July 1, 2025 through June 30, 2026, incorporated into the capitation rates through a risk-based rate adjustment.

Uniform increase provided by the eligible public safety net hospital established by the state for inpatient and outpatient hospital services for the rating period covering October 1, 2024 through September 30, 2025, incorporated into the capitation rate through a separate payment term of up to $388,500,819.

A pay-for-performance initiative focused on behavioral health performance improvement among acute care hospitals for the rating period covering July 1, 2025 through June 30, 2026, incorporated into the capitation rates through a separate payment term of up to $147,000,000.

A pay-for-performance initiative focused on maternal health performance improvement among acute care hospitals licensed to provide Labor and Delivery Services for the rating period covering July 1, 2025 through June 30, 2026, incorporated into the capitation rates through a separate payment term of up to $63,000,000.

Minimum fee schedule established by the state for specialty physician services and behavioral health outpatient services for the rating period, October 1, 2024 through September 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.

Uniform percentage increase, entitled Access to Professional Services Initiative, established by the state for qualified practitioners affiliated with one of the designated hospitals for the rating period covering October 1, 2024 through September 30, 2025, incorporated into the capitation rate through a separate payment term of up to $310.4million.

Uniform percentage increase established by the state for Differential Adjusted Payments (DAP) program eligible providers for the rating period covering October 1,2024 through September 30, 2025, and incorporated in the capitation rate through a risk based adjustment.

A uniform increase established by the state for qualified licensed professionals employed by the University of Washington and/or a member of its affiliated physician practice plans or employed by a public hospital or other public entity for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $120,526,551.76.

Uniform increase for eligible inpatient and outpatient services at eligible private hospitals for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $1,039,037,720.

Minimum and maximum fee schedules established by the state for Sub-Acute Psychiatric Community-Based Psychiatric and Recovery Center services for the rating period, January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a risk-based rate adjustment.