PPE Reimbursement Law Clarification

The Office of the Insurance Commissioner (OIC) recently provided clarification regarding SB-5169, legislation that mandates health benefit plans (insurance carriers that offer medical plans) to reimburse health care providers for PPE effective immediately and for the duration of the COVID-19 federal health emergency designation.

• Plans that do not offer medical coverage (e.g., dental and vision plans that are not part of a medical plan) were not included in the legislation.
• SB-5169 does apply to health benefit plans (those that offer medical plans) that include embedded dental benefits because they meet the statutory definition for a health plan.
• SB-5169 specifically references the use of “the American Medical Association’s current procedural terminology code 99072 or as subsequently amended." Dental providers should use that CPT code when billing health benefit plans with embedded dental benefits.

Delta Dental of Washington recently announced that while not covered under SB-5169, they will provide an additional round of practice support to Delta member dentists. Details on Delta’s second round of support will be coming soon.

WSDA has contacted carriers that are affected by this legislation seeking clarification and guidance on how dental offices may bill health plans with embedded dental benefits. We will share additional details with WSDA members when they become available.

Sincerely,