Dental services
Dental coverage information, including resources and training for HCA enrolled providers serving clients with Apple Health (Medicaid) coverage.
On this page
Overview
Oral health is an important part of overall physical health. In Washington, more than one in four people receive their health care from Apple Health (Medicaid). The Apple Health Dental program provides oral health and dental services to approximately 2 million Washingtonians, including children. Apple Health Dental is a fee-for-service program.
Children under 20 are eligible for a broad array of services under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program. The Access to Baby and Child Dentistry Program (ABCD) and Mouth Matters are two key programs that expand access to young children in the dental and medical settings, respectively. ABCD has been a national model for success, and is attributed to higher utilization rates for children Medicaid enrollees, as compared to the national average.
Washington State also offers adult dental coverage. The benefit provides essential oral health services, such as:
- Emergency care
- Diagnostic care
- Prevention
- Restorative
- Oral surgery
- Removable prosthodontics
Billing guides and fee schedules
- See the following programs on the provider billing guides and fee schedules page.
- Dental program
- Access to Baby and Child Dentistry (ABCD)
- Orthodontic services
- Dental program
- ProviderOne Billing and Resource Guide
Forms
- Dental forms (denture acceptance, denture appliance request, etc.)
- Mobile anesthesia subcontractor reporting form
- General information for authorization
- Prior authorization pend forms submission cover sheet
Biller and provider training
- How to bill for Apple Health services
- Prior authorization submissions
- How to check a client's benefit limits using the benefit limit inquiry
- How to Make Billing Orthodontics Easy
- Direct data entry webinar (how to bill Apple Health services with ProviderOne)
- WAC resources
Program resources
- Enroll as a Provider
- Overview of Apple Health pediatric dental coverage
- ABCD website
- Overview of adult dental coverage
- Department of Health Oral Health
- Includes information related to Washington's Oral Health programs like the Smile Survey, fluoridation, school sealant programs, and finding oral health care for patients with special needs
- Community Resources Online – 2-1-1
- The Center for Pediatric Dentistry
- DentistLink
Dental data
Find dental utilization and performance metrics for the Apple Health (Medicaid) dental programs.
Additional resources
- Bree Collaborative dental opioid recommendations
- Arcora Foundation oral health data dashboards and reports
- Department of Health: Washington State oral health system performance dashboard
- ASTDD older adult oral health promotion toolkit
- ADA Teledentistry technical report
- ASTDD guidelines for silver diamine fluoride
- CA perinatal oral health guidelines
- Seal America
- Opioids