Dental Services

Authorization is required for all dental care.

How do I get authorization?

L&I (State fund):
Complete one of the following and fax it to 360-902-4567.

  1. The American Dental Association (ADA) Claim form. Make sure you select “Request for Predetermination/ Preauthorization” in section 1.
  2. The L&I preauthorization form.
    Note: Completing either of these forms creates a high priority work item for the claim manager. These forms have proven highly effective in expediting authorizations.

Contact the Self-Insured Employer

Why you should become a network provider

Dental providers practicing in Washington must join L&I’s Medical Provider Network in order to treat injured workers beyond the initial visit.

  • We will pay non-network dentists for treatment performed only on the patient’s initial visit. The initial visit is when the provider is assisting the injured workers in completing the Report of Accident (ROA) or Provider’s Initial Report (PIR). 
  • Most dental treatments would not qualify as an initial visit. 
  • To provide ongoing treatment and get paid for it, you must be an L&I network provider.
  • Become an L&I provider (both network and non-network). 

Coverage and treatment information

The treatment plan and/or alternative treatment plan must be completed and submitted before authorization can be granted.

L&I is adopting the New Bree/AMDG dental guideline for prescribing opioids on April 1, 2018. We encourage you to review the guideline and adopt its best practices.

Here are the changes that may affect your practice:

  • In most dental cases, prescribe non-opioid analgesics as first-line treatment for pain control, unless contraindicated.
  • Access the state’s PMP and review the worker’s controlled substance history before prescribing an opioid.
  • If opioids are warranted, prescribe the lowest effective dose for 3 days or less (e.g. 8 to 12 tablets) and in combination with first-line treatment.
  • Complete a prior authorization form if more than a 3-day supply is needed.

This guideline was developed in partnership a broad advisory group, including members of the Dr. Robert Bree Collaborative, AMDG and dentists in general care and specialty areas.  The guideline reflects the best available clinical and scientific evidence and a consensus of expert opinion.

Billing and payment policies

Related rules

WAC 296-20-01010 Scope of health care provider network.
WAC 296-20-110 Dental.
WAC 296-23-160  General information and instructions.
WAC 296-20-06101 What reports are providers required to submit.


For information and resources on keeping your own workplace safe, visit our Dentistry topic page.

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