Statutes, codes, and regulations
Washington Administrative Code
Title 182 - Health Care AuthorityWASHINGTON APPLE HEALTH
Chapter 182-535A - Orthodontic services
Section 182-535A-0050 - Orthodontic treatment and orthodontic-related services-Authorization and prior authorization

Wash. Admin. Code § 182-535A-0050

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Current through Register Vol. 24-23, December 1, 2024
Section 182-535A-0050 - Orthodontic treatment and orthodontic-related services-Authorization and prior authorization

When the medicaid agency authorizes a limited orthodontic treatment, full orthodontic treatment, or orthodontic-related services for a client, including a client eligible for services under the EPSDT program, that authorization indicates only that the specific service is medically necessary; authorization is not a guarantee of payment. The client must be eligible for the covered service at the time the service is provided.

Wash. Admin. Code § 182-535A-0050

Amended by WSR 14-08-032, filed 3/25/14, effective 4/30/2014
Amended by WSR 20-03-042, Filed 1/8/2020, effective 2/8/2020
Amended by WSR 21-18-006, Filed 8/18/2021, effective 1/1/2022

11-14-075, recodified as §182-535A-0050, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.04.050, 74.08.090. 08-17-009, § 388-535A-0050, filed 8/7/08, effective 9/7/08. Statutory Authority: RCW 74.08.090, 74.09.520 and 74.09.035, 74.09.500. 05-01-064, § 388-535A-0050, filed 12/8/04, effective 1/8/05. Statutory Authority: RCW 74.08.090, 74.09.035, 74.09.520, 74.09.500, 42 U.S.C. 1396 d(a), C.F.R. 440.100 and 225. 02-01-050, § 388-535A-0050, filed 12/11/01, effective 1/11/02.