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Dental General Manual, Covered Services and Bulletins


Dental Manuals

Dental Manual (Updated_1.1.17)
Dental Fee Schedule Effective 11.14.16
Dental Fee Schedule Effective Until 11.13.16
Provider Medicaid and State Health Care Benefit Plan 10.1.16
Dental Manual Q3 2016 (Valid 7/1/16 - 9/30/16)
Dental Manual Q2 2016 (Valid 4/1/16 - 6/30/16)
Dental Manual Q1 2016 (Valid 1/1/16 - 3/31/16)

To search for specific information within the PDF document, select Ctrl F on your keyboard and type your keyword in the find box.

Dental Provider Workshop/Visits

Dental Billing Presentation 2016
Dental Policy Presentation 2016

Important Dental Information


Electronic Billing Mandate October 1, 2016

October 1, 2015 all provider who used diagnosis codes and bill more than 25 claims per year were mandated to bill electronically.  Dental providers were given a one (1) year exemption from this mandate due to not billing with diagnosis codes.  In an effort to be consistent among all Medicaid providers, dental providers will be required to bill electronically effective October 1, 2016. Please prepare your offcie for this implementation.  You may request an exemption if your office submits less than 25 claims per year.  Contact Dental Services with any questions related to electronic billing or exemption requests at 1-888-863-5806 or visit the Medicaid website for full details

Severe Crippling Malocclusion Program

SM Presentation 8.26.14
Interceptive Program 2.10.15
Web Portal Billing Presentation

Dental Bulletins and Forms

Additional Links

Medicaid and State Healthcare Benefit Plans: Provides client benefit plan names, descriptions, eligibility limitations, coverage types and coverage limitations. This information is useful when determining if a client is eligible for services.
Carrier Code List: List of Insurance Carrier Codes and Names