Online trainings and materials on Medicaid's EPSDT benefit for DC providers, agencies, and families...

This website provides access to trainings and resources for providers in DC who see children covered under Medicaid:

  1. HealthCheck Training This training will fulfill your obligations for all MCOs with which you are paneled.* You will receive 5 CME’s upon completion of the curriculum.**

  2. Fluoride Varnish Training This training will fulfill your obligations to provide and bill for fluoride varnish application in the District.

  3. DC Children's Health, Wellness, and Education Calendar The Health and Well-Being Subcommittee of the State Early Childhood Development Coordinating Council has developed this online calendar of events that includes health/wellness/educational items.

*MedStar Family Choice; AmeriHealthDC; Health Services for Children with Special Needs (HSCSN); CareFirst Community Health Plan of DC; and Fee-For-Service Medicaid Providers.

** Georgetown University Medical Center designates this curriculum for a maximum of 5 hours in category 1 credits towards the AMA Physician’s Recognition Award. CME credits will be paid for by the MCOs when you are due for HealthCheck training. Providers must be trained once every 2 years.

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Oral Health News

  • The Connecting Kids to Coverage National Campaign wants to remind families that with Medicaid and the Children’s Health Insurance Program (CHIP) coverage, children and teens up to age 19 can receive the necessary dental care, including regular check-ups, x-rays, fluoride treatments, dental sealants, and fillings, to keep them healthy and smiling. The Campaign offers a variety of resources:
    - Twitter and Facebook graphics are available in English and Spanish to share on social media.
    - Tip sheet with advice on sharing dental health education materials.
    - Find a Dentist tool to locate a dentist in their area that accepts Medicaid and CHIP.
  • Materials specifically for expectant mothers, toddlers, and children with special needs on their Oral Health Initiative page.
  • Note on Billing for Fluoride Varnish. 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. 
    1.     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.
    2. 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.
  • 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.

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