top of page

Direct Access has Arrived!


It's official.  HB 1116 is law. 


As of July 1, 2018, dental hygienists in Indiana can enter into access practice agreements with an Indiana licensed dentist.  This allows patients to have direct access to a dental hygienist without prior authorization from a dentist. Thanks to the amazing hard work of your IDHA Leadership, this bill proudly passed through the Indiana House of Representatives and Senate with no votes of dissent.  The bill was signed by Governor Holcomb on June 4, 2018.

Access Practice Agreements

What is Direct Access?

Direct Access refers to the ability of a dental hygienist to initiate treatment based on their assessment of a patient’s needs, without the specific authorization of a dentist, treat the patient without the presence of a dentist, and maintain a provider-patient relationship.

It is the position of the ADHA that oral health care—a fundamental component of total health care—is the right of all people.

Lack of access to oral health care is a critical issue in the United States due to disparities in the health care delivery system.

What does HB 1116 actually allow a dental hygienist to do?

This bill allows dental hygienists to enter into direct patient care without prior authorization (examination) by a dentist.


The DDS and DH will have to enter into a contract (that will be available from IDA and IDHA) and utilize consent forms (templates will also be available from IDA and IDHA) to help with patient acknowledgement and possibly compliance.


The bill is intended for preventive therapies (others can be completed in the setting WITH authorization by a DDS) and will require electronic charting to be considered. 


You can find the legislation here:

What is an Access Practice Agreement (APA)?

An Access Practice Agreement is a contract between a dentist, dental hygienist, and a facility that allows a dental hygienist to enter into direct access in Indiana. 


An Access Practice Dentist (APD) is a DDS with an Indiana license that has entered into an APA with a dental hygienist. 


As Access Practice Dental Hygienist (APDH) is a DH with an Indiana license that has entered into an APA with a dentist.

Is an APA the same as independent practice? 


Direct access in Indiana is in no way/shape/form dental hygiene independent practice.

The APDH cannot work under an APA setting without entering into a contract with a APD. 


In addition, all billing is completed through the DDS. This legislation does not authorize direct reimbursement for an APDH.

Access Practice Agreement

Sample Contract

Access Practice Agreement

Sample Consent Form

Frequently Asked Questions Regarding Access Practice Agreements

Useful Links for Hygienists interested in APAs

bottom of page