Important Update on Medicaid Adult Dental Rates

Dear WDA Members,


I want to provide an important update regarding the final state budget and its impact on adult dental Medicaid reimbursement rates.


After reviewing the finalized budget and the recently issued fee reduction memo, it has been confirmed that the Legislature approved a reduction to adult dental Medicaid rates. Specifically, the final budget includes a 50% reduction to the 100% rate increase that was implemented two years ago. Please see the attached memo from the Washington State Health Care Authority for more information.


Given the state's significant budget deficit and a declining revenue forecast, this outcome, while disappointing, was not entirely unexpected. Although we worked to prevent these cuts throughout the session, the final budget negotiations prioritized other areas.


The Health Care Authority is now required to implement the reductions based on the Legislature’s appropriation. While this is a setback, it's important to note that the adult dental Medicaid program remains intact—unlike during previous budget shortfalls when the program faced complete elimination.


Looking forward, we will remain fully engaged during the next legislative session to advocate for the restoration of funding and to guard against further reductions.


Thank you for your continued dedication and support.


Sincerely,

Carolyn Logue

WDA Lobbyist

Apple Health (Medicaid) dental rate reductions effective July 1, 2025


Adult and children's Apple Health (Medicaid) dental rates will be reduced beginning July 1, 2025.



Due to the impact on participating providers, the Health Care Authority (HCA) has published a draft fee schedule with the rate changes. 

State budget background


Governor Ferguson signed the Washington State budget on May 20, 2025. The Legislature identified reductions to both the adult and children’s Apple Health dental fee-for-service rates within the budget.



The Access to Baby and Child Dentistry (ABCD) and Orthodontic Program rates were not included in these reductions. Specific language regarding rate reductions and how they were applied can be found on page 235 of Conference Report ESSB 5167.

 

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