Apple Health (Medicaid) Provider Alert

Attention Dental providers:

EPA Code #870001607 Ending

Effective for dates of service on and after May 11, 2023, the Health Care Authority (HCA) is ending the use of expedited prior authorization (EPA) #870001607, associated with CDT® codes D9222, D9223, D9239, and D9243 for general anesthesia and intravenous sedation related to a dental emergency.  Prior authorization requirements for these procedure codes will resume.

This change aligns with the ending of the federal public health emergency.

CDT code D0170 Discontinued

Effective for dates of service on and after May 11, 2023, HCA is also discontinuing the use of CDT® code D0170, reevaluation/established patient for all providers except orthodontists.

HCA updated the Dental-Related Services Program Billing Guide to reflect these changes.