New York State Medicaid covers a maximum of 4 annual fluoride varnish applications, once every three months, for children from birth until 7 years of age. Fluoride varnish is currently reimbursable to non-dental providers such as physicians and nurse practitioners.
Starting Oct. 1, 2020, fluoride varnish can be applied by additional primary care provider types including Registered Nurses and Physician Assistants, based on scope of practice, to optimize treatment.
Providers should be trained and competent in fluoride varnish application. For training resources, visit the New York State Department of Health’s website.
Non-dental providers should continue to use Current Procedural Terminology (CPT) code 99188 when submitting claims.
