Washington Apple Health psychotherapy coverage: codes, telehealth and limits
The short answerApple Health covers 90837 (60-minute psychotherapy) and 90785 in its outpatient mental health coverage table. Only one 90791 or 90792 is paid per client per provider per calendar year without a limitation extension. Licensed associates use their associate taxonomy, adding the claim note 'LMHP associate' for dual-eligible clients.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · Washington. Public policy, not the member's benefits.
Washington Apple Health
Apple Health (Medicaid) Mental Health Services Billing Guide, October 1, 2026 · Washington
| 90785 | Listed [1] |
|---|---|
| 90791 | Limited (one per client per provider per calendar year) [1] |
| 90837 | Listed [1] |
| Telehealth rules | Telemedicine is covered under the Mental Health Services program. The guide points to HCA's Telehealth page for the telemedicine policy and the audio-only procedure code lists. [1] |
| Visit limits | HCA pays only one psychiatric diagnostic interview exam (90791 or 90792) per client, per provider, per calendar year; more sessions need a limitation extension request. 90791 or 90792 and psychological testing cannot be billed on the same day without prior authorization. [1] |
| Who can bill | Licensed mental health professionals include LICSWs, LASWs, LMFTs and LMHCs, and their associates (LSWAIC, LASWA, LMFTA, LMHCA) share the matching taxonomy. For dates of service from January 1, 2026, associates use their associate taxonomy or 101Y00000X for Medicaid-only clients, and their associate taxonomy with the claim note 'LMHP associate' for dual-eligible clients. The guide also notes licensed associates cannot bill Medicare. [1] |
- Washington Apple Health (HCA): Mental Health Services Billing Guide (Oct 1, 2026), checked October 30, 2026
What Washington Apple Health's documents say
The table above has every field we found for Washington Apple Health, with numbered sources. In short:
- Visit limits. HCA pays only one psychiatric diagnostic interview exam (90791 or 90792) per client, per provider, per calendar year; more sessions need a limitation extension request. 90791 or 90792 and psychological testing cannot be billed on the same day without prior authorization.
- Who can bill. Licensed mental health professionals include LICSWs, LASWs, LMFTs and LMHCs, and their associates (LSWAIC, LASWA, LMFTA, LMHCA) share the matching taxonomy. For dates of service from January 1, 2026, associates use their associate taxonomy or 101Y00000X for Medicaid-only clients, and their associate taxonomy with the claim note 'LMHP associate' for dual-eligible clients. The guide also notes licensed associates cannot bill Medicare.
- Telehealth rules. Telemedicine is covered under the Mental Health Services program. The guide points to HCA's Telehealth page for the telemedicine policy and the audio-only procedure code lists.
- Codes. 90785 and 90837 are listed. 90791 is limited.
Check Washington Apple Health's claim against the row
Before the claim goes out, compare it with the row above: the code matches the session length you documented, the place of service and modifier fit a video or audio-only visit, and the rendering clinician's license is one the payer enrolls. The psychotherapy table compares Medicaid with every other payer we checked.