Dental program changes, effective 1/1/2022

Apple Health (Medicaid) Provider Alert

Effective for dates of service on and after January 1, 2022, Apple Health (Medicaid) will implement the following changes to the Dental Program:

Access to baby and child dentistry (ABCD):

Effective for dates of service on and after January 1, 2022, the Access to Baby and Child Dentistry (ABCD) program will expand to include children with disabilities who are age 0 to 13 and have a Developmental Disabilities Administration (DDA) indicator. Providers must be ABCD-trained and certified to receive enhanced rates for ABCD services.

For more information on ABCD training and certification, providers can contact their local ABCD program. HCA will update the Access to Baby and Child Dentistry (ABCD) Billing Guide to reflect this new information.

Orthodontic Services:

Effective for dates of service on and after January 1, 2022, interceptive orthodontic treatment will no longer be a covered service. This change is due to the removal of CDT codes D8050 and D8060. HCA revised Chapter 182-535A WAC and will update the Orthodontic Services Billing Guide to reflect this new information.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.