It’s official! As of July 1, 2021, the Washington State Health Care Authority (HCA) has increased reimbursement rates by 100% for nearly all adult dental services covered by Apple Health (Medicaid) dental for fee-for-service providers. The HCA dental program and community partners are working every day to enroll new Apple Health dental providers, and to offer the help and assistance needed to serve Apple Health patients. For more details on these increased rates, visit the HCA fee schedule page or access the dental program fee schedule document here (updated as of 7/1/2021).

Washington’s Medicaid dental rates have long been among the lowest in the country, making it difficult for providers to participate in the program. The result is that Apple Health dental coverage, while essential, does not always equate to access to care. These new increased reimbursement rates for Apple Health adult dental services show real progress in our state’s commitment to improving oral health equity.

What this means for Washington’s dental practices

If you already accept Apple Health dental insurance, you’re all set! As of July 1, you will automatically see and start to receive increased reimbursements for covered services for adult Apple Health enrollees.

If you’re not currently taking Apple Health dental insurance, now is great time to enroll as an Apple Health provider and grow your practice with new patients! Learn more about the Apple Health dental program on the HCA website. When you’re ready to sign up, visit the HCA to Enroll as a Provider.

How to get the most out of accepting Apple Health dental insurance

Arcora Foundation is here to help your practice be successful in serving patients with Apple Health through trainings, referrals, and enhanced reimbursement programs.

  • Apple Health Dental Billing Basics: Arcora Foundation’s newest continuing education course is a free, one-hour, self-paced course that describes the nuts and bolts of signing up, billing, and caring for this underserved patient population. This course was developed in partnership with the HCA and is designated for one CDE credit hour.
  • DentistLink patient referrals: DentistLink is a free non-profit referral service, funded by Arcora Foundation. With DentistLink, our skilled, friendly team can refer Apple Health enrollees to you to help you grow your patient base.
  • Enhanced Apple Health reimbursement opportunities: All providers who serve kids under age six can receive enhance reimbursement through the Access to Baby and Child Dentistry (ABCD) program. If you’re a provider in Spokane, Thurston, or Cowlitz counties, you can receive enhanced reimbursement as part of the Oral Health Connections pilot program, which serves pregnant people and adults with diabetes.
Now is the time to make a difference in the health of adults in Washington. We hope Washington dental providers play a part.
More Health Care Authority Resources