August 5, 2014
Effective September 1, 2014, the Medicaid payment rate for D8080 Comprehensive Orthodontic Treatment of the Adolescent Dentition will be cut. The Health Care Authority (HCA) has decided to cut reimbursement rates for the orthodontic codes because utilization was too high for their budget. HCA had to cut $11.5 million from their budget so they have decided to take some or all of those cuts from the pediatric orthodontic budget. The reimbursement rates were approximately 75% of UCR and were, to WSDA’s knowledge, the highest rates (compared to UCR) in the entire dental Medicaid program.
The current rates are still posted on the HCA’s website but the updated rates are expected to be posted prior to September 1st.
View a copy of the July 30, 2014 correspondence from the HCA announcing the rate cuts here.
Please make sure to check WSDA’s blog for any related updates.