Recent update on Washington Apple Health Dental Coverage

WA Apple Health Dental Update Presentation 2016.03

On March 9, 2016, Pierce County Oral Health Coalition members and others convened to gain insight and updates on Washington State’s Apple Health (Medicaid) dental coverage for children and adults. In her presentation, Dianne Baum, Dental Program Administrator for Washington Apple Health shared: status and scope of dental benefits provided to our state’s residents who qualify for Apple Health benefits, state-wide Apple Health dental provider statistics, and important information on state provider audit programs and potential audit criteria and triggers.

Providers are responsible for checking the HCA website for updates. Washington’s Apple Health Dental Billing Guides are updated quarterly: January, April, July and October. There is a separate guide for the Access to Baby and Child Dentistry (“ABCD”) program. Ms. Baum suggested signing up for “go-delivery” e-mails and visiting the Dental webpage.

An engaging question and answer session followed the presentation, focused primarily on preauthorization of dental services and other claims handling issues. Ms. Baum’s presentation included helpful links and contact information for providers. Apple Health clients will also find valuable information about their benefits on HCA’s “For Clients” page, including a current summary of adult dental benefits.

This was incredibly helpful and specific information for dental billers, and nice to have additional Health Care Authority Apple Health resource information,” remarked one participant.

Presentation Handouts:


Free dental services at March 2015 Project Homeless Connect

Project Homeless Connect returns to the Washington State Fairgrounds, Puyallup  on Tuesday, March 31, 2015. As in the past, the Pierce County Dental Society, along with other Pierce County Oral Health Coalition partners, will provide much needed dental assessments and treatment triage.

Doors open 9:00 AM – 3:00 PM.

PCOHC members interested in helping in the dental area should email

For more information and to share with the community as appropriate, click here for the event flyer: PHC_Flyer_March_2015_WA Fair Grounds

Oral health procedures to be covered by adult dental Medicaid starting in January

State health officials have released additional information concerning dental procedures that will be covered for Medicaid-eligible adults in Washington state, starting on Jan. 1, 2014.

An update on those procedures was recently shared at November meeting of the Washington Coalition on Medicaid Outreach by Dianne Baum, dental program manager for the Washington State Health Care Authority (HCA). The covered procedures include exams, X-rays, cleanings, fluoride varnish, fillings, periodontal care, root canals, dentures, extractions, and emergency services. Crowns will not be covered.

See the presentation for more details and the HCA’s news release from Oct. 10, 2013.

Starting in January, the Washington Medicaid Program will resume covering dental services for all adults with Medicaid. This includes residents who already have Medicaid and people who are eligible for “expanded Medicaid,” made possible by federal health care reform.