Attention Medicaid Providers: The Washington State Health Care Authority (HCA) recently published updates to the Dental-related Services billing guide and Orthodontic Services billing guide.
Attention Medicaid Providers: The Washington State Health Care Authority (HCA) recently published updates to the Dental-related Services billing guide and Orthodontic Services billing guide. The changes to the Dental-related Services billing guide became effective October 1, 2023, and the changes to the Orthodontic Services billing guide became effective September 14, 2023.
All of the changes that have been made are listed at the beginning of the billing guides under the “What has changed?” section. The recent changes to the Dental-related Services billing guide include clarification of criteria for when not to bill for silver diamine fluoride, clarification that only one buccal/facial and one lingual surface per tooth are covered, as well as clarification on billing for nonsurgical periodontal services. Among other updates, the revision also notes what HCA does not cover through teledentistry.
The changes to the Orthodontic Services billing guide include clarifying billing processes for limited orthodontic treatment and clarifying requirements for the supporting documents needed when submitting a prior authorization request.
Dental-Related Services Billing GuideOrthodontic Services Billing Guide