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Note on Billing for Fluoride Varnish. Since FY 2014, DC Medicaid primary care providers who have completed fluoride varnish training can bill the Fee-for-Service (FFS) Medicaid program and the Medicaid Managed Care Organizations (MCOs) for fluoride varnish application on a child under 3 (three) years of age. Currently, DC Medicaid primary care providers who are enrolled and trained by DC HealthCheck can bill FFS and the MCOs for the application of fluoride varnish using CDT code D1206 or CPT code 99188. When this policy was implemented in 2014, CDT code D1206 was the only procedure code for fluoride varnish application and since then CPT 99188 code was added to the fee schedule.
Effective March 1, 2018, DC Medicaid (FFS and the MCOs) will no longer reimburse primary care providers for fluoride varnish claims submitted using the CDT code D1206. Only fluoride varnish claims submitted by primary care providers using the CPT code 99188 will be processed and paid. All fluoride varnish claims received by primary care providers for visits that occurred before March 1, 2018 will be processed. However, any varnish claims received by primary care providers for a date service after March 1, 2018, will only be paid if the claim for fluoride varnish application is coded using the CPT code 99188.
SAVE the DATE: Medical & Dental Integration Provider Training. Join DC Medicaid providers to learn about the latest trends in oral health. Topics to be covered include ED use for patients with non-traumatic dental complaints, and oral health services for expecting mothers. Please share the attached save the date flyer with your colleagues, and medical & dental provider networks.
February 28, 6-8pm: Read More
Provider Training: Medical & Dental Integration
Topics include: use of ED by patients with non-traumatic dental complaints, oral health services for pregnant women.
- Oral Health Messaging Guide. The District of Columbia identified various barriers that prevent beneficiaries from accessing oral health services, including lack of oral health literacy and understanding on how to access oral health services. To help address this issue, DHCF compiled an oral health messaging guide, which participants of the Children’s Oral Health Initiative can use when developing materials or speaking with children and families enrolled in the DC Medicaid program. The attached guide includes oral health messaging targeted to dental providers, primary care providers, and parents. The purpose of this guide to provide simple and effective oral health messaging to educate District of Columbia families about the importance of children’s oral health and regularly seeing their primary dental provider. This messaging comes directly from the Maryland Oral Health Coalition’s Oral Health Campaign, which has been proven effective in increasing oral health literacy of low-income families.We encourage you to use the messaging featured in this guide when developing materials or talking points about oral health for District families.
- New ADA State Fact Sheets on Geographic Access to Dental Care. The American Dental Association (ADA) Health Policy Institute published one-page infographic for each state, including the District of Columbia, highlighting access to dental care for Medicaid beneficiaries. The District’s fact sheet highlights that 100% of publicly insured children live in areas where there is at least one Medicaid dentist per 2,000 publicly insured children within a 15-minute travel time. Click here to learn more.
- January Children’s OHI Meeting. Our next Children’s Oral health Initiative Meeting is on Wednesday, January 3: 2-3:30pm. With the ring of the New Year, we will try something new! The January OHI meeting will be hosted as a webinar only. In-person attendance for the January meeting won’t be necessary. An updated meeting invitation with the WebEx link and meeting agenda will be sent out next week.
- Read the DCHF Transmittal: Transmittal 17-04-National Children's Dental Health Month, Dental Procedures and Billing Requirements - 524.7 KB (pdf)
- Oral Health Messaging Guide. The guide can be used when developing materials or speaking with children and families enrolled in DC Medicaid program and includes oral health messaging targeted to dental providers, primary care providers, and parents. The purpose of this guide to provide simple and effective oral health messaging to educate District of Columbia families about the importance of children’s oral health and regularly seeing their primary dental provider.