Orthodontic treatment - Payment methodology not changing 7/1/2019

Washington State Health Care Authority sent this bulletin at 07/01/2019 12:55 PM PDT

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Apple Health (Medicaid) Provider Alert

Attention Dental Providers:

The Health Care Authority (HCA) has heard your concerns and is re-evaluating the decision to change the payment methodology for orthodontic treatment provided to Apple Health clients beginning July 1, 2019. Please disregard the Provider Alert sent on June 14, 2019. HCA will not be implementing this change and will not be publishing a revised Orthodontic Services Billing Guide, effective July 1, 2019.

Dental providers should continue billing for orthodontic services as they currently are, using the billing instructions found in the current Orthodontic Services Billing Guide, dated April 1, 2019, found on HCA’s Billers and Providers webpage, under billing guides and fee schedules.

HCA encourages dental providers and billers to sign up to receive early notices of Apple Health rulemaking pertaining to orthodontic services. Sign up for rulemaking notices through HCA’s Rulemaking webpage.

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 two million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, and, beginning in 2020, the School Employees Benefits Board (SEBB) 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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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.