INTERPRETIVE OR POLICY STATEMENT
Legal and Administrative Services
Subject: EPSDT medicaid provider guide (MPG).
The EPSDT MPG Added procedure code 90672 to list of no cost immunizations from the department of health, replaced code D1203 with D1208 for topical application of fluoride, and clarified limits.
For additional information, contact Amber Lougheed, HCA, P.O. Box 45504, phone (360) 725-1349, TDD/TTY 1-800-848-5429, fax (360) 586-9727, e-mail firstname.lastname@example.org, web site http://www.hca.wa.gov/.