Dental only plan — Coverage for same day procedures.
RCW 48.43.747
in effect(1) A dental only plan offered by a carrier or limited health care service contractor, as defined in RCW 48.44.035 , may not deny coverage for procedures solely on the basis that the procedures were performed on the same day. (2) Nothing in this section shall prevent a dental only plan offered by a carrier or limited health care service contractor from denying a claim for coverage where such denial relates in whole or in part to any of the following: (a) Limitations intended to prevent fraud, waste, and abuse; (b) A claim indicating unbundling of procedure elements where payment for a service bundles multiple procedure elements; (c) Clinical appropriateness; (d) Medical necessity; (e) A final benefit decision that has been pended due to the need for further documentation or provider narrative; or (f) Plan benefit limitations.
(1) A dental only plan offered by a carrier or limited health care service contractor, as defined in RCW 48.44.035 , may not deny coverage for procedures solely on the basis that the procedures were performed on the same day.
(2) Nothing in this section shall prevent a dental only plan offered by a carrier or limited health care service contractor from denying a claim for coverage where such denial relates in whole or in part to any of the following:
(a) Limitations intended to prevent fraud, waste, and abuse;
(b) A claim indicating unbundling of procedure elements where payment for a service bundles multiple procedure elements;
(c) Clinical appropriateness;
(d) Medical necessity;
(e) A final benefit decision that has been pended due to the need for further documentation or provider narrative; or
(f) Plan benefit limitations.
Source: WA Statutes (Official Site)URL: https://app.leg.wa.gov/RCW/default.aspx?cite=48.43&full=trueFetched: 6/29/2026