HCA: Orthodontic Information Form (HCA 13-666) Reminder

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HCA: Orthodontic Information Form (HCA 13-666) Reminder

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

Attention Orthodontic providers:

Reminder to billers of orthodontic services!

When completing the Health Care Authority’s (HCA’s) Orthodontic Information (HCA 13-666) form, you must complete Part III, the Washington Modified Handicapping Labiolingual Deviation (HLD) Index Score, for all prior authorization requests. This is not a new requirement. Instructions for completing the Orthodontic Information form are located in HCA’s Orthodontic Services Billing Guide.

Effective immediately, HCA will reject forms submitted without the HLD score.

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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Questions? Please email info@wsda.org.
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