HCA: Change In How to Check for Available Units for CDT Codes

Dental Medicaid

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HCA: Change In How to Check for Available Units for CDT Codes

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

Dental - Change In How to Check for Available Units for CDT Codes

Attention Dental providers:

The Health Care Authority (HCA) has discovered that the Client Limit Inquiry feature in ProviderOne is not able to calculate available units for CDT® procedure codes that require an arch or quadrant designation as required in the Dental Services Billing Guide. Examples of these are CDT® codes D4341 and D4210.

If you need to check available limits for CDT® codes that require an arch or quadrant designation, use one of the following options:

  • Use the Secure Contact Us web form, or
  • If the date of service is within 48 hours, call HCA’s Medical Assistance Customer Service Center (MACSC) at 1-800-562-3022, choose “provider services,” and follow the prompts. All other requests must use the Secure Contact Us web form.

Note: When you are filling out the Secure Contact Us web form, make sure to select the topic Service Limits to ensure prompt processing.

CDT® codes and descriptions only are copyright 2021 American Dental Association

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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