PCPs Can Provide Fluoride Varnish Application for Pediatric AHCCCS Members

Primary Care Providers (PCPs) play a key role in reaching children who may not have regular dental visits or access to care. The application of fluoride varnish is a billable service for PCPs who have completed the required training.

Guidelines for Application:

• Fluoride varnish can be applied during an EPSDT visit for members as early as six months of age, as long as one tooth or more have erupted.
• Additional applications may be reimbursed every three months during EPSDT visits, until the member’s fifth birthday.
• Providers must ensure oral health screenings are conducted according to the AHCCCS EPSDT Periodicity Schedule (see AMPM Policy 430 – Attachment A).

Please note: Fluoride varnish applied by a PCP does not replace a visit to a dental provider. Members should still be referred to a dentist for comprehensive oral health care.

Training & Reimbursement Requirements:

• Providers must complete AHCCCS-required training for fluoride varnish application.
• Recommended training is available at: https://www.aap.org/en/patient-are/oralhealth/oral-health-education-and-training/
• Upon completion, submit a copy of the training certificate to: hchcredentialing@azblue.com

(This is required prior to reimbursement.)

Billing Code:

• CPT 99188 – Application of topical fluoride varnish by a physician or other qualified healthcare professional.

Thank you for supporting the oral health of our members.