SHJ26-008 VALLEY HEALTH SERVICE AGREEMENT - PARTIALLY EXECUTED

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ATTACHMENT "B" COMPENSATION THE COUNTY WILL NOT PROCESS PAYMENT FOR SERVICES RENDERED UNDER THIS AGREEMENT UNTIL CONTRACTOR SUBMITS A COMPLETED W-9 (SEE ATTACHMENT "E"). As full compensation for covered clinical services under Attachment "A," the County shall pay Contractor one hundred percent (100%) of the Washington Apple Health (Medicaid) fee -for -service maximum allowable amount effective on the date of service for the correctly documented code, modifier, unit, provider type, age, place of service, and facility or non -facility designation. "Medicaid -equivalent rate" means that amount, including any generally applicable HCA enhancement or reduction for which the service and rendering provider qualify, without requiring the client or service to be payable by Medicaid. The controlling schedules are: (a) mental health and psychology services, the HCA Mental Health and Psychology Services Fee Schedule; (b) substance use disorder services, the HCA Substance Use Disorder Fee Schedule and applicable Service Encounter Reporting Instructions (SERI); and (c) behavioral -health practitioner and medication -management services, the HCA Physician -Related Services/Health Care Professional Services Fee Schedule. HCA's billing guides and coverage rules determine the correct code and rate. The companion Clinical Operations MOU contains a rate -verification table using the July 1, 2026, schedules. If HCA publishes no rate for a requested service, including court, training, meeting, or administrative time, the parties must agree to a written rate before the service is performed. Contractor will invoice monthly. Each invoice will identify the service date, category, code, modifier, units, rendering provider type, applicable HCA schedule and effective date, insurance status or payer disposition, and calculated amount. Undisputed amounts are due within thirty (30) calendar days. The County must identify disputed items in writing within fifteen (15) calendar days and timely pay all undisputed portions. Undisputed amounts not paid within thirty (30) calendar days accrue interest as provided by chapter 39.76 RCW. Contractor will first bill Medicaid, Medicare, or private insurance only when coverage is active on the date of service, the individual and service are eligible, the service is lawfully payable in the correctional setting, and Contractor is authorized to bill. The County will reimburse Contractor at the Medicaid -equivalent rate in Attachment "B" when the client lacks active insurance at the time of the visit, coverage cannot be verified, incarceration or payer policy prevents payment, or the claim is denied for a reason other than Contractor billing error. Contractor need not wait for a denial when eligibility records establish that no payer is available. The County will not condition payment on collection from the client, and Contractor will not bill the client. Unless otherwise provided herein, Contractor shall be solely responsible for Contractor's travel and related expenses. Kittitas County Agreement for Services (rev. 5/14/25) Page 8 of 23