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Apple Health (Medicaid) Provider Alert: Attention Orthodontic Providers

Orthodontic billing: Periodic orthodontic treatment visits (CDT® D8670) must be billed in three-month intervals. The first three-month interval begins after the initial placement date. The claim must include the appliance placement date and must match the banding claim that the Health Care Authority (HCA) has reimbursed. If that date does not match, the periodic (D8670) orthodontic treatment claim will be denied

Orthodontic Billing

Periodic orthodontic treatment visits (CDT® D8670) must be billed in three-month intervals. The first three-month interval begins after the initial placement date. The claim must include the appliance placement date and must match the banding claim that the Health Care Authority (HCA) has reimbursed. If that date does not match, the periodic (D8670) orthodontic treatment claim will be denied.

This is not a new requirement. For additional questions, please refer to HCA’s Orthodontic Services Billing Guide or contact the Dental Program directly. 

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