HCA: 30-day grace period on requiring prior authorization for replacement dentures

Dental Medicaid

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HCA: 30-day grace period on requiring prior authorization for replacement dentures

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

30-day grace period on requiring prior authorization for replacement dentures

In response to the provider alert sent on July 27, 2021, regarding replacement dentures requiring prior authorization, the Health Care Authority (HCA) will allow a 30-day grace period for CDT® codes D5110 and D5120, procedures in progress. The prior authorization requirements for replacement dentures will be effective for all claims with dates of service on and after September 2, 2021.

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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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