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Changes to Covered Apple Health Dental-related Services

Jul 8, 2021
The Health Care Authority (HCA) has announced rule changes to covered Apple Health (Medicaid) dental-related services.

The Health Care Authority (HCA) has announced rule changes to covered Apple Health (Medicaid) dental-related services. Multiple sections of WAC 182-535 (Dental-related services) have been amended including:

  • The definitions of certain services.
  • Covered diagnostic services.
  • Covered preventative services.
  • Dental-related covered restorative services.
  • Dental-related covered prosthodontic services.
  • Dental-related covered oral and maxillofacial surgery services.
  • Covered adjunctive general services.
  • Dental-related services for clients of the developmental disabilities administration of the Department of Social and Health Services.
  • Obtaining prior authorization for dental-related services.
  • Access to Baby and Child Dentistry (ABCD) program.

The updated rules will become effective Aug. 1, 2021, and more details on the amendments for each section can be reviewed here.