HCA: Apple Health Provider Alert

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

HCA: Apple Health Provider Alert

The Health Care Authority (HCA) has announced a significant revision to the Medicaid provider guidelines for dental services.

The Health Care Authority (HCA) has announced a significant revision to the Medicaid provider guidelines for dental services.

Effective February 1, 2024, the frequency schedule for limited visual oral assessments, specifically CDT® codes D0190- Screening of a patient, D0191-Assessment of a patient and D1330 – Oral hygiene instruction will increase, permitting providers to see clients twice per calendar year, as opposed to the previous limitation of twice per 12 months. This change is designed to better align with school-based oral health programs. As a reminder, these codes are allowed only in non-dental office settings.

The updated guidelines will be detailed in the April 1, 2024, edition of the Dental-Related Services Program Billing Guide.

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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