Welcome to the District of Columbia's HealthCheck Fluoride Varnish Training. This series of four modules is designed to provide Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) medical providers and other health providers with knowledge needed to reduce the incidence of dental caries among children ages 3 and under and to contribute to the establishment of a dental home.
This curriculum will fulfill your training requirements to apply and bill for fluoride varnish to children covered by HealthCheck in DC. You need to successfully complete the quiz at the end of the course.
New and Noteworthy
- Read DHCF's transmittal on reimbursement to trained primary care providers for fluoride varnish application for patients under three years of age.
- The DC Pediatric Oral Health Coalition (DCPOHC) is pleased to announce that technical assistance will be available for EPSDT primary care providers and their staffs to implement fluoride varnish application into their medical practices.
- 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.
The curriculum was developed by a multidisciplinary team of experts. Click here for a list of authors and reviewers.
Following DC Department of Health Care Finance, bill for fluoride varnish applications for patients under three years of age using the CPT Code 99188.