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Parents and ......................................... |
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Reimbursement is Available for Delivering Preventive Oral Health Services |
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Medicaid Periodic oral evaluation (D0120)* • Eligibility: One periodic oral evaluation is allowed every six months through age 5 per provider per client• Frequency: 2 times in 12 months • Reimbursement rate: $29.46 for certified providers Application of fluoride (D1203) • Eligibility: Medicaid-enrolled child under the age of 19• Frequency: 3 times in 12 months for children through age 5 2 times in 12 months for ages 6 through 18 • Reimbursement rate: $13.25 Family oral health education (D9999)* • Eligibility: limited to one visit per day per family per provider• Frequency: up to 2 visits in a 12-month period through age five, per provider, per client. • Reimbursement rate: $27.58 for certified providers *WDS Foundation training required to receive reimbursement for these services Washington Dental Service/Delta Dental of Washington Periodic Oral Evaluation (D0120) • Eligibility: WDS-enrolled child from birth-3 years• Frequency: 2 times in 12 months • Reimbursement amount: up to $43 Application of fluoride (D1203) • Eligibility: WDS-enrolled child from birth-3 years• Frequency: 2 times in 12 months • Reimbursement amount: up to $36 For more information on reimbursement, email Madlen Caplow at mcaplow@deltadentalwa.com or call (206) 473-9542. |
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