Dental Medicaid

Updated Apple Health Billing Guides and Fee Schedule

Attention Medicaid Providers: The Washington State Health Care Authority (HCA) recently published updates to the Access to Baby and Child Dentistry, Dental-related Services, Orthodontic Services, and Oral Health Connections Pilot Project billing guides, along with updates to the Dental Program fee schedule.

HCA: Provider Directory – December 2021

HCA: Dental Program Changes, Effective Jan. 1, 2022

Updates from the Health Care Authority (HCA) on the Access to Baby and Child Dentistry (ABCD) program and covered orthodontic services.

Apple Health (Medicaid) Provider Alert

Attention Orthodontic providers: For dates of service on and after January 1, 2022, HCA will require providers to request prior authorization for CDT® codes D8680 and D8695. HCA will discontinue EPA for these codes.

HCA and Apple Health Provider Directory Update

HCA will make a new Provider Directory tool for Apple Health (Medicaid) clients available on December 10, 2021 through this API. This impacts providers who are contracted with HCA, and Apple Health clients. To prepare for this launch, HCA is requesting all contracted providers to update their ProviderOne provider file.