Orthodontic Services Billing Guide, effective 8/1/19

Dental Medicaid

WSDA is committed to keeping our members up to date on the latest news and information involving Washington state's Dental Medicaid program.

COVID-19: HCA has created a web page ​for COVID-19 information. For Medicaid provider information, scroll down to the "Providers" section.

Latest Medicaid News

Orthodontic Services Billing Guide, effective 8/1/19

Please read the following message from the HCA: 

The Health Care Authority (HCA) revised the Orthodontic Services Billing Guide, effective August 1, 2019.

What has changed?

The agency updated the following information in this guide:

  • Removed restrictions on replacement retainers
  • Added requirements and instructions regarding discontinued treatment
  • Added coverage criteria for severe malocclusions

For specific details on these changes, see the “What has changed” table inside the updated guide. The updated billing guide is located on HCA’s Provider billing guides and fee schedules webpage.

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.

Learn More

Questions? Please email info@wsda.org.
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