WSR 05-02-088

INTERPRETIVE OR POLICY STATEMENT

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

[ Filed January 5, 2005, 9:38 a.m. ]


DESCRIPTION OF INTERPRETIVE OR POLICY STATEMENT


Document Title: Billing Instructions.

Subject: Orthodontic services.

Effective Date: January 8, 2005.

Document Description: These are billing instructions for authorized orthodontic services providers to use when billing for medical assistance eligible clients. Included in this document are client eligibility, provider requirements, coverage, authorization, orthodontic information sheet, billing, fee schedules, how to complete the ADA form.

To receive a copy of the interpretive or policy statement, contact Barbara Salmon, Rules and Publications Section, Department of Social and Health Services, Medical Assistance Administration, Division of Program Support, P.O. Box 45533, Olympia, WA 98504, phone (360) 725-1349 or go to website http://maa.dshs.wa.gov/download/publicationsfees.htm (click on "Numbered Memos," "Year 2004"), TDD 1-800-848-5429, fax (360) 586-9727, e-mail salmobl@dshs.wa.gov.

December 27, 2004

Ann Myers, Acting Manager

Regulatory Improvement Project

Washington State Code Reviser's Office