SoonerCare Fluoride Varnish

Oral Health and Children

  • Early childhood caries (cavities) is the No. 1 chronic disease affecting young children.
  • Early childhood caries is five times more common than asthma and seven times more common than hay fever.
  • Tooth pain keeps many children home from school or distracted from learning.
  • Children are recommended to have their first dental visit by age 1.

The American Academy of Pediatrics Section on Oral Health and Chapter Oral Health Advocates provide education, training and advocacy for pediatricians, dentists, other health professionals and families.

Together we can make a difference by improving communication and collaboration between the medical and dental homes and making pediatricians and other health professionals an essential part of the oral health team. 

Training and Certification for Medical Home Providers

  • Complete online web based training offered by Smile for Life Oral Health Curriculum
    • Two sessions are required: Course 2 - Child Oral Health and Course 6 - Fluoride Varnish
    • Physicians must complete both sessions to be eligible for reimbursement. Staff may provide service but must also complete above training in addition to the provider.
    • Providers are also strongly encouraged to complete Course 7 – The Oral Examination
     
  • Print and add SoonerCare Provider ID number under the certificate number (please allow a couple of weeks for certificate to be e-mailed to you).
  • FAX certificate of completion to 405-530-7137 (example of certificate).
  • Order supplies while waiting for certification to be e-mailed. Under oral health practice tools, select where to get varnish materials. http://www.aap.org/oralhealth/PracticeTools.html

Payment and Billing

OHCA Policy 317:30-3-65.8(c). Separate payment will be made to the member’s primary care provider for the application of fluoride varnish during the course of a well-child screening (EPSDT) for members aged 6 months to 60 months. 

Reimbursement is limited to two applications per year by eligible providers who have attended an OHCA-approved training course related to the application of fluoride varnish.

The fluoride varnish should be supplied by the provider’s office. OHCA recommends a 5 percent sodium fluoride varnish. See a list of vendors under order supplies.

Reimbursement for application of the varnish must be billed with procedure code CPT 99188 during a well-child exam.

For more information about this benefit, call the Provider Service Line 1-800-522-0114, option 1.