Updated Apple Health Billing Guides

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.

Latest Medicaid News

Updated Apple Health Billing Guides

Attention Medicaid Providers: The Washington State Health Care Authority (HCA) recently published updates to its Dental-Related Services Program Billing Guide and Orthodontic Services Billing Guide.

Attention Medicaid Providers: The Washington State Health Care Authority (HCA) recently published updates to the following Washington Apple Health Billing Guides:

All of the changes that have been made are listed at the beginning of each billing guide under the “What has changed?” section. Some of the recent changes include policy clarifications, policy updates, billing clarifications, the addition of new CDT codes, and general housekeeping items. 

Please note the HCA has also published the Oral Health Connections (OHC) Pilot Project Billing Guide. This ​three-year pilot project is intended to gain additional information on whether enhanced oral health services for diabetic or pregnant Medicaid clients age 21 to 64 could lead to improved health outcomes and reduced health care costs. This program is restricted to clients receiving services in Cowlitz, Spokane and Thurston counties. 

The HCA has also updated the Dental Program Fee Schedule.

All updates and changes to billing guides and fee schedules are made quarterly (January 1, April 1, July 1, & October 1). 

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.

Learn More

Questions? Please email info@wsda.org.
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