# WAC 296-20-022: WAC 296-20-022. Payment of out-of-state providers

> Washington · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_022

## Section

- **Citation:** WAC 296-20-022
- **Heading:** WAC 296-20-022. Payment of out-of-state providers
- **Jurisdiction:** Washington
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Washington Administrative Code / Title 296 / Chapter 296-20 / Section 296-20-022

## Text

(1) How will health care providers outside of Washington state be paid? All health care service providers, regardless of their geographic location, will be paid according to the fee schedule rules, rates, coverage and payment policies as published in the Washington state Medical Aid Rules and Fee Schedules and/or provider bulletins.
(2) Can an injured worker be charged for services? In all cases, the department's maximum allowed fees and payment levels are the maximum payable. If a provider's charge exceeds the maximum amount payable under the department's Medical Aid Rules and Fee Schedules , the provider must not charge the injured worker for the difference. A provider violating this provision may be held ineligible to treat injured workers as provided by department rules and may be subject to other applicable penalties.
Exception:
When a provider treats an injured worker for condition(s) unrelated to the worker's accepted industrial injury or illness, the provider may bill the worker or other insurers for the unrelated services only.
(3) What services will be paid to providers outside of Washington? Only those diagnostic and treatment services authorized under the state of Washington medical aid rules, fee schedules, payment policies, or medical coverage decisions may be authorized or paid by the department or self-insurer. As determined by the department of labor and industries, the scope of practice of providers outside the state of Washington may be recognized for payment purposes. However, in all cases WAC 296-20-03002 (Treatment not authorized) shall apply. Specifically, services not authorized under Washington workers compensation rules, fee schedules, payment policies, or medical coverage decisions will not be paid, even if permitted under the workers compensation program in the provider's state or country of business. When in doubt, the provider should verify coverage of a service with the department or self-insurer.

## Nearby sections

- [WAC 296-20-010 WAC 296-20-010. General information](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_010.md)
- [WAC 296-20-015 WAC 296-20-015. Who may treat](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_015.md)
- [WAC 296-20-020 WAC 296-20-020. Acceptance of rules and fees](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_020.md)
- [WAC 296-20-022 WAC 296-20-022. Payment of out-of-state providers](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_022.md)
- [WAC 296-20-023 WAC 296-20-023. Third-party settlement—Excess recoveries](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_023.md)
- [WAC 296-20-024 WAC 296-20-024. Utilization management](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_024.md)
- [WAC 296-20-025 WAC 296-20-025. Initiating treatment and submitting a claim for benefits](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_025.md)
- [WAC 296-20-030 WAC 296-20-030. Treatment not requiring authorization for accepted conditions](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_030.md)
- [WAC 296-20-035 WAC 296-20-035. Treatment in cases that remain open beyond 60 days](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_035.md)
- [WAC 296-20-045 WAC 296-20-045. Consultation requirements](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_045.md)
- [WAC 296-20-051 WAC 296-20-051. Consultations](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_051.md)
- [WAC 296-20-055 WAC 296-20-055. Limitation of treatment and temporary treatment of unrelated conditions when retarding recovery](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_055.md)
- [WAC 296-20-065 WAC 296-20-065. Transfer of providers](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_065.md)
- [WAC 296-20-071 WAC 296-20-071. Concurrent treatment](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_071.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_296_20_022. Check the current official text before relying on it. Not legal advice.