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HEAI.THCARE <br />WASHINGTON MEDICAID AND WASHINtrON EENEFIT PTANS FORTHE UNINSURED BEHAVIORAL HEAI,TH PROFESSIONAL RTIMBURSEMENTSCHEDUIE <br />lllmev!il\tsh3xcycoqord <br />&r'ildH\*bilcdf,unrrdudB'onrMrb4rNry r-* <br />lHohc <br />v!il NewF t eycryon*: Mild lt$ hiled Ebd\HDdnion lld comldito <br />lHme <br />v!il sgw R r Ney coryod tu,Jd H(, &bilcJ I $4 \d Deiion \ld coryldly <br />l)r <br />esloe <br />llrm. <br />v!il sew R J ky.@on*: cory'tuik E\. r@Ehi€li\fl rld htid rbd(-@le$ly r*- <br />lllone <br />vLil Netr R3 Keycoryond: cmFehne Hr corychEicE(m.\H hiion\bdcoql.{ry r"'" <br />lHomvnil <br />Nesft t kycqondr: ( mp,ffis! rr\:( @Ehtr.rw \rd h'nonrrod(!4k{ry r-" <br />lHof,c <br />vli NewF J eycoryond: GmpMir lL\:.wreki.Fw\rdhinonNbd(bqletry r"" <br />ll <br />h-. vbil Ndv R r R.y coqond compr&bn. HY. c@dhir Elm\H kidon \bd.oql.{ly <br />lil.e$/P <br />lHof,. <br />Vlil lewF J kycoryond comprtuneltt: (-wrekEn.L(lfu\ld Le\srollod(bqr.urv l'-* <br />llhne <br />vLil r_cw R I Keyc@onil:.onp'&En. H\. c@(hi!Erm\H knion\bJcoqk{ry r*- <br />lHonsvnil\twft <br />I xeyhond: (-omp'*Enc Ey. cbmEhtrcr\mrH h'im Jor, !4rcsry r** <br />lllom.\ <br />lir:_e{ ft 3 kvcoryond: comriehlie II\. GryftbBncEt4\ld hnior \bdcbryldly t^-" <br />llh-c <br />v!il se"A r kyc.a.n*..ory'&cie H\:.omEhi.E\m\rd h!'d vodcoqk{ly <br />ln <br />reloP <br />lllre <br />vnil \t* A 3 evcoqoFd comF.kn. H\(bryd*trcErmlH hlEn rrSLmprL{ry r-" <br />ll <br />hrc vnil r_s\ ft 3 Ruy c@orM ComF€kn. H\corydftnt Etm\d Nrion HsI.omPlc{ry r"^" <br />151.97 <br />lHon.Met <br />N.w h r xryconpnenE: cnpreh.neiv. hj6mp'pheniv. urnjMd kR'on ts'8h@mphrry r-" <br />lHon.van <br />N.w fr I Xq(omFh.nL:GmFchentyc Hrjbmptehenriv. &rm;Md knion HEhchpFiry <br />BA5 <br />lHom.Mrt <br />New Pt I Xq(ompn.nb: (omr.hensiv€ kj6mpr.heniivc e?n;Md k.hlon HahGhpl.iry <br />lH.n.M.il <br />N"* Pr I kqCompnents:6m!,ehcn$r tujbmp'ehensive krmjMd kilon HdhGmPld'q <br />l,'4s/oP <br />lHoneM,t <br />New Pr 3 xrycompn.na: Gmp,€hc.eiv€ bjGmp,.h.nrto. &rmjMd &.tsro. Hdh@mprcriry <br />lHomeM.il <br />New P' r xrycompients: Gmpreh.Biv. ki6mp'chenn. &rmjMd &d'on HBhchphiry <br />lH...v"rNew <br />Pt 3 Xq(o-F.enb: bnp'€hcns'G kj6mprcheneive krmiMd Dd'on H€hGnplciity <br />lztsetP <br />lHoneM'tNew <br />Pt I xrycomFn.nb:Gmpiehcnive hi6mprch.n{c hrn;Md ed!on HBh@hpk{q <br />lHon.M1il <br />r{ Pr rr (e/comFnenc: P'ob rtru! lnrfllkj peb f(u. t/.m: ttdtod Md eiiion <br />Itomevet[.i <br />n r' r.rr.-F^ents: Prob lcbe lnlrlki Prob rtrusrrrmj srdM Md &(aion u,t <br />lHo..M,il <br />h! Pr )' (rycomNients: Prob rftb! lnrNlk; Prob rcutt,.m: trntod Md e.kion <br />lGil/P <br />lHomeu,it&r <br />Pt 2' xeycomFr.nts: P'ob 146 r.rorBj r,ob Fd <br />lHom.u!' <br />ti Pt r+ Ke/ComFF.nL: Prob rdur ln!frlH{j Pob kus t/.m: stdM Md edbn t""* <br />lHomesrttil <br />Pt F Xry(omFn.nb: P'ob rdus l.rolHrj Pbb rGueu:mi lrdtu Md &dio. <br />| <br />tr esloP <br />lHom.s!il <br />t{ P' h xeyconFn <br />lHomeu\il <br />r{ Pt r+ KerconFienG: Prob ra ur lnrNlH\j Pdb kus t\.m:5ldtod Md eiiion <br />TG <br />lHomeMilk' <br />n r' kycohFnents: Prob ldue lnlNlhi Pmb rtru\ rtrmjstdtod Md &(tsion <br />lHonesrttil <br />Pt h Kry(omFn.nb: P'ob rdus lniillH\j t,ob kur tuni srdtud Md &asion <br />| <br />tr esloe <br />ItsomevEittn <br />Pt 2' xrycomFnents:Frpind Pbb kurrnl h;&p'nd P'obrdushrm;M€d h( bkGmp <br />lHomeuil <br />t* Pt2. xeycomNne.tsr,pand P'ob reur hr Hr;&p.nd P,obr(u'&.m;Mrd D.c b*6mp s7.42 <br />llbmev!illrrh, <br />xqGqondEsdPobFeBIdrlrFpsdEobFocBcero\ldhb{fory <br />lcx4 <br />lHom.vsilFilR2 <br />Keycoqon*EsdPohFdGIdEdv$dkobFocqEvn\HDdbw{bq r-* <br />Focu Ese\ld h ks cory <br />lHomu <br />vtuilEilA l Key.oryond Esd rdb tsNGrd Erts$$d Fob rbLB Lv4r'd &t but!4 r'** <br />lHonevn <br />&t Pt I kvcomFnrnb+rpind Prob r*us hl Hr;&Fnd p'obrduskrm;Md &c b* 6mp <br />lHoneWtE3ttt <br />2r xrvbmFnenB:uprnd Pbb rdur hl h,&p'nd t'obrduskrmjMd &( bw6mp <br />loroioP <br />lHomeMil <br />t{ et 2t x€y6mrnenB:Ep,nd P'ob Fcus rnr h;bp.nd P'obr(u'sam;Md ec b*bnp <br />lHomeVrtBtt' <br />r' kvbmFn"nb:6p.nd Pbb l4ur Inl k;EFnd P'obldusurdiMd k( bwGnp t**- <br />lHom€Vdr <br />B' P' r. ky("-F"pnB: &uilGd lnld ki &laid k,mj Md e!$ion trd Gnpleriry <br />lors/P <br />lHom€vnil <br />ktPtF xcycomFn r.m: Md edsion ftd Gmp.nry r-- <br />lHonrM{r <br />r*ft 2+ K€ycodFne.a: &uil.d lnd &i &r.nd Ex.m: Md &(tsion hd cdpr.rit <br />lHomcVil <br />B' Pr r' kyGmFn?nE: &uil€d lnd kj DclaJd r:rnj Md fturion kd GmdAiry r'" <br />lHom.v6r <br />BtPtF kvconFnens: huil.d lnd Hr: oet.ild tx.mj Md Dedeion hd cnp'eih <br />ln <br />senP <br />lHomev6il <br />BtPtF (eyConpn.na: hbihd hd k: &r.lld E{.m: Md D.(tsion hdcnprerit <br />I6 <br />lsom.Mn <br />k' Pr r. kybdtsn€nE: &biled lnd hi e'aJd rirmj Md &(ion trd Gnpr.riry r'93,51 <br />lHon.vFr <br />BtPtF f,sc".F"rnB: huil?d lnd H< &t.ld tr.ftj Md k.tsion hdGnp'e^ity <br />1020/0P <br />93.51 <br />lHon€Vn <br />BtPr I xrycomFnrnB: hbil.d lntu &:oct.id Er.h: Md Dsrtsion hdGnele,ity <br />Md &rBlon kdOnlleriq 93.51 <br />lHon.Mir <br />kl Pi r. {Gycomrn€na:6mprch.ntto. tu;cmp'€hGnrile&.m; Mod/Hithemlbaq <br />lors/P <br />lHoil.wr <br />hr P' t' xryconFn€nE:6mp'ehenrl. k:chp'fhfmtoe e.m; Mod/Hish6mpr.iiq <br />lnom.vil <br />r{ft 2. xeycomFnrnB:enp'eh.nsne H/,Ghprehenrtue erm; ModAb6dplcx[Y <br />lHoneMn <br />Br pr h nqc".F"FnB:bnp'€hensry. h;&mp'ch.nttue k,n; Mod/HishGDdcilv <br />lo)o/oP <br />lHon.Msr <br />ktfi F rcycomFn <br />lHon.M.il <br />h' Pr I xry6mpnenB:6mp'ehemto. b;6np'.henri. k.nj Mod/HEh 6mplrxiry