Apple Health (Medicaid) Provider Alert

Effective for dates of service on and after Jan. 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 Jan. 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.

(Editor's Note: This policy change is the result of WSDA member-driven legislation. Through the efforts of WSDA, our members, and other oral health advocates, we were able to pass legislation that will ensure some our state’s most vulnerable populations will be provided with comprehensive dental benefits, a dental home, and better chance of maintaining a lifetime of good oral health.)

Orthodontic Services:

Effective for dates of service on and after Jan. 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.

CDT® codes and descriptions only are copyright 2020 American Dental Association