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Apple Health (Medicaid) Provider Alert

Attention Orthodontic providers: For dates of service on and after January 1, 2022, HCA will require providers to request prior authorization for CDT® codes D8680 and D8695. HCA will discontinue EPA for these codes.

Attention Orthodontic providers:

Currently, the Health Care Authority (HCA) allows providers to use the expedited prior authorization (EPA) process for payment of CDT® code D8680, appliance removal, construction, and placement of retainers and D8695, appliance removal.

For dates of service on and after January 1, 2022, HCA will require providers to request prior authorization for CDT® codes D8680 and D8695. HCA will discontinue EPA for these codes.

HCA will update the January 1, 2022, Orthodontic Services Billing Guide to reflect this new information.

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