# WAC 284-43B-015: WAC 284-43B-015. Coverage of emergency services

> Washington · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_015

## Section

- **Citation:** WAC 284-43B-015
- **Heading:** WAC 284-43B-015. Coverage of emergency services
- **Jurisdiction:** Washington
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Washington Administrative Code / Title 284 / Chapter 284-43B / Section 284-43B-015

## Text

(1) Coverage of emergency services is governed by RCW 48.43.093 . Emergency services, as defined in RCW 48.43.005 , include services provided after an enrollee is stabilized and as part of outpatient observation or an inpatient or outpatient stay with respect to the visit during which screening and stabilization services have been furnished. Poststabilization services relate to medical, mental health or substance use disorder treatment necessary in the short term to avoid placing the health of the individual, or with respect to a pregnant person, the health of a person or their unborn child, in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.
(2) A carrier may require notification of stabilization or inpatient admission of an enrollee as provided in RCW 48.43.093 . Regardless of such notification, payment and cost-sharing for poststabilization services provided by a nonparticipating facility, provider or behavioral health emergency services provider and dispute resolution related to those services are governed by RCW 48.49.040 and 48.49.160 .

## Nearby sections

- [WAC 284-43B-010 WAC 284-43B-010. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_010.md)
- [WAC 284-43B-015 WAC 284-43B-015. Coverage of emergency services](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_015.md)
- [WAC 284-43B-020 WAC 284-43B-020. Balance billing prohibition and consumer cost-sharing](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_020.md)
- [WAC 284-43B-025 WAC 284-43B-025. Balance billing prohibition and consumer cost-sharing for ground ambulance services](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_025.md)
- [WAC 284-43B-027 WAC 284-43B-027. Payments to nonparticipating ground ambulance services organizations](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_027.md)
- [WAC 284-43B-029 WAC 284-43B-029. Local governmental entity rate reporting to the insurance commissioner](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_029.md)
- [WAC 284-43B-030 WAC 284-43B-030. Out-of-network claim payment and placing a claim into dispute](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_030.md)
- [WAC 284-43B-032 WAC 284-43B-032. Applicable dispute resolution system](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_032.md)
- [WAC 284-43B-035 WAC 284-43B-035. Arbitration initiation and selection of arbitrator](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_035.md)
- [WAC 284-43B-037 WAC 284-43B-037. Arbitration proceedings](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_037.md)
- [WAC 284-43B-040 WAC 284-43B-040. Determining whether an enrollee's health plan is subject to the requirements of the act](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_040.md)
- [WAC 284-43B-050 WAC 284-43B-050. Notice of consumer rights and transparency](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_050.md)
- [WAC 284-43B-060 WAC 284-43B-060. Enforcement](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_060.md)
- [WAC 284-43B-070 WAC 284-43B-070. Self-funded group health plan opt in](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_070.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43B_015. Check the current official text before relying on it. Not legal advice.