Dental Medicaid

WSDA is committed to keeping our members up to date on the latest news and information involving Washington state's Dental Medicaid program.

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Latest Medicaid News

Dental Pediatric Medicaid Reimbursement Rate Increase

Mar 18, 2022
Beginning Jan. 1, 2023, reimbursement rates for dental pediatric Apple Health services will increase.

During the 2022 legislative session, the Legislature allocated $21.1 million (FY 2023) in additional funding in the Supplemental Operating Budget to improve access to care for our state’s Medicaid (Apple Health) eligible children through increased fee-for-service reimbursement rates.

WSDA is very pleased to report that, as a result, beginning Jan. 1, 2023, reimbursement rates for dental pediatric Apple Health services will increase in accordance with the language below:

  • The rates for codes for the Access to Baby & Child Dentistry (ABCD) program will be increased by 40 percent.
  • The rates for codes for children's dental program for persons aged zero to 20 years old that have a corresponding ABCD code will be increased to the current ABCD code rate, plus an additional 10 percent rate increase.
  • The rates for codes for children's dental program for persons aged zero to 20 years old without a corresponding ABCD code will be increased to 70 percent of the medical assistance rates on a fee-for-service basis for adult dental services in effect on Jan. 1, 2022. This increase does not apply to codes with rates already greater than 70 percent of the adult dental services rate.

Consider Enrolling as an Apple Health Provider

WSDA understands how challenging both Apple Health enrollment and billing can be for dentists and their teams. As such, we are pleased to share that the Arcora Foundation has created a free, pre-recorded continuing education course to walk you through both processes.

Access the Course
About Enrolling as an Apple Health Provider

Consider Becoming an ABCD Provider

With just a few hours of training, you can become a certified ABCD provider and help improve the oral health of our state’s Medicaid insured children, ages 0-6, by providing quality preventive care and treatment. Participating dentists receive enhanced fees for certain preventive and restorative procedures and family oral health education.

About Becoming an ABCD Provider

Sign Up for DentistLink

In an effort to increase dentist participation in the Apple Health program, WSDA has partnered with the Arcora Foundation to encourage dentists to sign up with DentistLink, Arcora’s free referral service, to start receiving referrals for Apple Health enrollees.

Please note that as an Apple Health provider, you have full discretion in determining the number of Apple Health patients seen at your practice.

Sign Up for DentistLink

Questions?

Please send any questions you may have to info@wsda.org. For questions specific to DentistLink, please email provider@dentistlink.org or call a DentistLink Outreach Specialist at (208) 771-0444.

Thank you to all of our members who currently see Apple Health patients!

Medicaid Transition to Managed Care Cancelled

The 2019 Legislature has directed the Washington State Health Care Authority (HCA) to continue to administer the dental Medicaid program through fee-for-service. The HCA may not proceed with a carved-out or carved-in managed care dental option at this time.

Learn More

Questions? Please email info@wsda.org.