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The Department of Health Care Services (DHCS) added Community Health Worker (CHW) services as a Medi-Cal benefit starting July 1, 2022. On, July 26, 2024, DHCS received federal approval to include CHW services as a benefit under Medi-Cal Dental, effective December 1, 2024. CHW services are preventive health services to prevent disease, disability, and other health conditions or their progression; to prolong life; and promote physical and mental health. CHWs may include individuals known by a variety of job titles, including promotores, community health representatives, navigators, and other non-licensed public health workers, including violence prevention professionals.
Under the covered CHW benefit, members will receive oral health education and navigation. CHWs provide oral health education to promote members’ oral health or address barriers to dental health care including providing information consistent with established or recognized oral health care standards. CHWs deliver oral health navigation to provide information, training, referrals, or support to assist members in accessing health care, understand the health care system, or engage in their own care. Additionally, CHWs connect members to community resources and may assist with a variety of concerns that impact Medi-Cal Dental members, including but not limited to, access to oral health care systems, oral health-related social needs, transportation services, and translation services.
Medi-Cal Dental CHWs will provide services under the supervision of an enrolled Medi-Cal Dental provider. DHCS updated the dental fee schedule to allow Medi-Cal Dental billing providers to be reimbursed for the CHW benefit under the Current Dental Terminology (CDT) code D9994 (Dental Case Management, Patient Education to Improve Oral Health Literacy).
If you have any questions, please feel free to send them to Dental@dhcs.ca.gov. DHCS appreciates your collaboration and partnership on this important effort.
Previous Informational Webinar
The Medi-Cal Dental Services Division hosted a Medi-Cal Dental Community Health Worker (CHW) informational webinar on October 31, 2024. The purpose of this meeting was for DHCS to share updates and information on the new Medi-Cal Dental CHW benefit and to provide dental stakeholders with a forum to provide input on Medi-Cal Dental to help improve the delivery of Oral Health Care services. The CHW webinar provided an overview of CHWs and focused on the CHW policy and requirements.
CHW Informational Webinar, October 31, 2024
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