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Non-Dental Practitioner Application of Fluoride Varnish in a Primary Care Setting

Posted 9/4/2020 at 11:47 AM

Fluoride varnish can be applied by multiple primary provider types

Effective August 1, 2020 for fee-for-service (FFS) and October 1, 2020 for Medicaid Managed Care (MMC), fluoride varnish can be applied by multiple primary provider types, based on scope of practice, to optimize treatment. This policy applies to mainstream MMC plans and HIV Special Needs Plans.

As a reminder, fluoride varnish is currently reimbursable with CPT code 99188. A maximum of four (4) annual fluoride varnish applications will be covered for children from birth until 7 years of age.

Providers eligible for reimbursement for this service include:

  • Physicians
  • Nurse practitioners
  • Physician assistants
  • Registered nurses

For more information, including training resources, click here.