Apple Health Provider Alert: Dental-Related Services Billing Guide

Washington State Health Care Authority sent this bulletin at 07/13/2017 08:35 AM PDT

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The Health Care Authority (agency) has published an updated Dental-Related Services Billing Guide, dated July 12, 2017. The updated billing guide contains revisions to CDT codes D3220 and D3221 as follows:

CDT code D3220 allowed for primary teeth only

CDT code D3221 allowed for permanent teeth only, including Medical Care Services (MCS) clients

Some of these restrictions were listed in the previously published billing guide under the “Description” column. They have been moved to the “Limitations” column.

The agency also added scaling in the presence of generalized moderate or severe gingival inflammation to the list of covered periodontal services for clients of the Developmental Disabilities Administration.

About the Health Care Authority (HCA)

The Washington State Health Care Authority purchases health care for more than 2 million Washington residents through Apple Health (Medicaid) and the Public Employees Benefits Board (PEBB) 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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Apple Health Provider Alert: Dental-Related Services Billing Guide

See the Health Care Authority's provider billing guides and fee schedules page to view additional guides and fee schedules.

About the Health Care Authority (HCA)

Disclosure notice