Oral Evaluation & Fluoride Varnish in the Medical Home

What is Oral Evaluation and Fluoride Varnish in the Medical Home?

Oral Evaluation and Fluoride Varnish in the Medical Home offers limited services aimed at improving the oral health of children from 6 through 35 months of age.

Who is Eligible to Provide this Service?

Texas Health Steps enrolled physicians, physician assistants, and advanced practice registered nurses.

Certification

Providers must attend an OEFV training offered by the Texas Health Steps Dental Program to become certified to bill for this service. All other medical team members are encouraged to attend the training.

Completion of this course does not certify you to bill Medicaid for oral evaluations and fluoride varnish. If you are a Physician, Physician's Assistant, or Advanced Practice Nurse and wish to receive certification to perform this service and bill Medicaid, you must provide additional certification information.

The certification code is placed on the Texas Health Steps TPI under which the provider bills their Texas Health Steps medical checkups.

Please contact Louise Friedman at 512-776-2110 or email if you have questions.

Training

Take free Continuing Education courses through the Texas Health Steps Online Provider Education website. The OEFV course was developed by the Texas Health Steps Dental Program. The goal of the module is to introduce Texas Health Steps medical providers and other interested healthcare professionals to best practices for promoting oral health in children from 6 through 35 months of age. Upon completion of this module, Texas Health Steps physicians, physician assistants and advanced practice registered nurses are given the option to print a registration form to complete and fax to Texas Health Steps Dental staff to become certified to provide OEFV services in their practice.

To take the online training, visit Texas Health Steps Online Provider Education website and click on "Find a Course", scroll down to Oral Health, and then click on Oral Evaluation and Fluoride Varnish for more information and enrollment.

What is Included in this Visit?

  • Intermediate oral evaluation.
  • Fluoride varnish application.
  • Dental Anticipatory guidance.
  • Referral to a dental home.

The services listed above must be performed in conjunction with a Texas Health Steps medical checkup.

How is this Service Billed to Texas Medicaid?

In conjunction with a Texas Health Steps medical checkup, utilize CPT code 99429 with U5 modifier.

Must be billed with one of the following medical checkup codes:

  • 99381
  • 99382
  • 99391
  • 99392

Federally qualified health centers and Rural Health Centers do not receive additional encounter reimbursement.

What Documentation is Needed?

  • Must document all components of OEFV on the documentation form provided during the training.
  • Keep record of the referral to a dental home.

Forms, Materials and Product Resources

Materials

Forms

The following PDFs are available for download only. They are not available for online ordering.

Product Resources

5% NaFluoride Varnish

Disposable Mouth Mirrors

Contact Texas Health Steps Regional Provider Relations Staff.

Download PDF

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