HCA: Removing prior authorization requirements for certain CDT codes for children

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HCA: Removing prior authorization requirements for certain CDT codes for children

The Health Care Authority (HCA) recently sent the following alert to dental Medicaid providers.

Apple Health (Medicaid) Provider Alert

Effective for dates of service on and after January 8, 2021, expedited prior authorization (EPA)/prior authorization (PA) is no longer required for CDT codes D2390, D2929, D2930, D2932, D2933, or D2934 for clients age 0-12.

A reminder alert will be sent on January 5, 2021.

The Health Care Authority (HCA) will publish an updated version of the Access to Baby and Child Dentistry Billing Guide on January 8, 2021.

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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.

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