# WAC 182-501-0055: WAC 182-501-0055. Health care coverage — How the agency determines coverage of services for its health care programs using health technology assessments > Washington · Regulations · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0055 ## Section - **Citation:** WAC 182-501-0055 - **Heading:** WAC 182-501-0055. Health care coverage — How the agency determines coverage of services for its health care programs using health technology assessments - **Jurisdiction:** Washington - **Kind:** Regulations - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Washington Administrative Code / Title 182 / Chapter 182-501 / Section 182-501-0055 ## Text (1) The medicaid agency uses health technology assessments to determine whether a new technology, new indication, or existing technology approved by the Food and Drug Administration (FDA) is a covered service under agency health care programs. The agency only uses health technology assessments when coverage is not mandated by federal or state law. A health technology assessment may be conducted by or on behalf of: (a) The agency; or (b) The health technology assessment clinical committee (HTACC) under RCW 70.14.080 through 70.14.140 . (2) The agency reviews available evidence relevant to a medical or dental service or health care-related equipment and uses a technology evaluation matrix to: (a) Determine its efficacy, effectiveness, and safety; (b) Determine its impact on health outcomes; (c) Identify indications for use; (d) Identify potential for misuse or abuse; and (e) Compare to alternative technologies to assess benefit vs. harm and cost effectiveness. (3) The agency may determine the technology, device, or technology-related supply is: (a) Covered (see WAC 182-501-0060 for the scope of coverage under Washington apple health (WAH) programs); (b) Covered with authorization (see WAC 182-501-0165 for the process on how authorization is determined); (c) Covered with limitations (see WAC 182-501-0169 for how limitations can be extended); or (d) Noncovered (see WAC 182-501-0070 for noncovered services). (4) The agency may periodically review existing technologies, devices, or technology-related supplies and reassign authorization requirements as necessary using the provisions in this section for new technologies, devices, or technology-related supplies. (5) The agency evaluates the evidence and criteria from HTACC to determine whether a service is covered under WAC 182-501-0050 (9) and (10) and this section. ## Nearby sections - [WAC 182-501-0050 WAC 182-501-0050. Health care general coverage](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0050.md) - [WAC 182-501-0055 WAC 182-501-0055. Health care coverage — How the agency determines coverage of services for its health care programs using health technology assessments](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0055.md) - [WAC 182-501-0060 WAC 182-501-0060. Health care coverage — Program benefit packages — Scope of service categories](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0060.md) - [WAC 182-501-0065 WAC 182-501-0065. Health care coverage — Description of service categories](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0065.md) - [WAC 182-501-0070 WAC 182-501-0070. Health care coverage — Noncovered services](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0070.md) - [WAC 182-501-0100 WAC 182-501-0100. Subrogation](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0100.md) - [WAC 182-501-0125 WAC 182-501-0125. Advance directives](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0125.md) - [WAC 182-501-0135 WAC 182-501-0135. Patient review and coordination (PRC)](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0135.md) - [WAC 182-501-0160 WAC 182-501-0160. Exception to rule—Request for a noncovered health care service](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0160.md) - [WAC 182-501-0163 WAC 182-501-0163. Health care coverage — Process for submitting a valid request for authorization](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0163.md) - [WAC 182-501-0165 WAC 182-501-0165. Medical and dental coverage — Fee-for-service (FFS) prior authorization — Determination process for payment](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0165.md) - [WAC 182-501-0169 WAC 182-501-0169. Health care coverage — Limitation extension](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0169.md) - [WAC 182-501-0175 WAC 182-501-0175. Medical care provided in bordering cities](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0175.md) - [WAC 182-501-0180 WAC 182-501-0180. Health care services provided outside the state of Washington — General provisions](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0180.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_501_0055. Check the current official text before relying on it. Not legal advice.