Dental/Orthodontic Payment Methodology Changes Delayed Until Further Notice

Dental Medicaid

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Dental/Orthodontic Payment Methodology Changes Delayed Until Further Notice

Please read the following message from the HCA.

Attention Apple Health orthodontic providers:

The Health Care Authority (HCA) sent a Provider Alert to Apple Health orthodontic providers on March 25, 2020, regarding changes to the payment methodology for comprehensive and limited orthodontic treatment effective July 1, 2020.

HCA is delaying implementation of the changes identified in this provider alert until further notice. Please continue to use CDT procedure codes D8030 and D8080. HCA will give ample notification to providers before the changes take effect.

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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