Access to Baby and Child Dentistry (ABCD) Billing Guide update

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Apple Health (Medicaid) Provider Alert

Attention Access to Baby and Child (ABCD) providers:

The Health Care Authority (HCA) revised the Access to Baby and Child Dentistry (ABCD) Billing Guide to align with the Expedited Prior Authorization (EPA) schedule (for CDT codes D2390, D2929, D2930, and D2933) in the Dental-related services billing guide.

For clients age 12 and younger, providers may use the appropriate EPA for CDT codes D2390, D2929, D2930, and D2933 if client meets EPA criteria. Prior authorization will continue to be required for clients who do not meet the EPA criteria or who are age 13 through 20 in accordance to WAC 182-535-1084(6).