HCA: Dental services end of EPA #870001607 and discontinued use of CDT® code D0170 – Effective May 11, 2023

Dental Medicaid

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Latest Medicaid News

HCA: Dental services end of EPA #870001607 and discontinued use of CDT® code D0170 – Effective May 11, 2023

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

Apple Health (Medicaid) Provider Alert

Attention Dental providers:

EPA Code #870001607 Ending

Effective for dates of service on and after May 11, 2023, the Health Care Authority (HCA) is ending the use of expedited prior authorization (EPA) #870001607, associated with CDT® codes D9222, D9223, D9239, and D9243 for general anesthesia and intravenous sedation related to a dental emergency.  Prior authorization requirements for these procedure codes will resume.

This change aligns with the ending of the federal public health emergency.

CDT code D0170 Discontinued

Effective for dates of service on and after May 11, 2023, HCA is also discontinuing the use of CDT® code D0170, reevaluation/established patient for all providers except orthodontists.

HCA updated the Dental-Related Services Program Billing Guide to reflect these changes.  

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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