Age 20 or Less
We pay for covered dental and dental-related services for children when they are:
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Within the scope of the eligible clients medical care program
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Medically necessary
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Within the standard of care; and
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Within accepted dental or medical practice procedures that are:
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Consistent with a diagnosis of dental disease or condition; and
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Reasonable in amount and duration of care, treatment, or service.
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Subject to the limitations and listings of non-covered procedures.
Eligibility, Fee Schedule, and Billing Instructions
for clients through age 20.
WAC Program Regulations:
388-535-1050 Dental-related definitions
388-535-1079 Dental-related services for clients
through age twenty - General
388-535-1080 Covered dental-related services for
clients through age twenty - Diagnostic
388-535-1082 Covered dental-related services for
clients through age twenty - Preventive services
388-535-1084 Covered dental-related services for
clients through age twenty - Restorative services
388-535-1086 Covered dental-related services for
clients through age twenty - Endodontic services
388-535-1088 Covered dental-related services for
clients through age twenty - Periodontic services
388-535-1090 Covered dental-related services for
clients through age twenty - Prosthodontics
(removable)
388-535-1092 Covered dental-related services for
clients through age twenty - Maxillofacial
prosthetic services
388-535-1094 Covered dental-related services for
clients through age twenty - Oral and maxillofacial
surgery services
388-535-1098 Covered dental-related services for
clients through age twenty - Adjunctive general
services
388-535-1099 Covered dental-related services for
clients of the division of developmental
disabilities
388-535-1100 Dental-related services not covered
for clients through age twenty
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