![]() Dental coverage in separate CHIP programs is required to include coverage for dental services "necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions." States that provide CHIP coverage to children through a Medicaid expansion program are required to provide the EPSDT benefit. The periodicity schedule for other EPSDT services may not govern the schedule for dental services. A referral to a dentist is required for every child in accordance with each State's periodicity schedule and at other intervals as medically necessary. States must consult with recognized dental organizations involved in child health care to establish those intervals. Dental services may not be limited to emergency services for children entitled to EPSDT.ĭental services must be provided at intervals that meet reasonable standards of dental practice, and at such other intervals, as indicated by medical necessity, to determine the existence of a suspected illness or condition. If a condition requiring treatment is discovered during a screening, the state must provide the necessary services to treat that condition, whether or not such services are included in a state's Medicaid plan.Įach state is required to develop a dental periodicity schedule in consultation with recognized dental organizations involved in child health care. The EPSDT benefit requires that all services must be provided if determined medically necessary. A referral to a dentist is required for every child in accordance with the periodicity schedule set by a state.ĭental services for children must minimally include: Though oral screening may be part of a physical exam, it does not substitute for a dental examination performed by a dentist. Medicaid covers dental services for all child enrollees as part of a comprehensive set of benefits, referred to as the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. See the 2010 Medicaid/CHIP Oral Health Services fact sheet for information on children's access to dental services and opportunities and challenges to obtaining care. States are required to provide dental benefits to children covered by Medicaid and the Children's Health Insurance Program (CHIP), but states choose whether to provide dental benefits for adults. Medicaid MAGI & CHIP Application Processing Timeĭental health is an important part of people's overall health.Testing Experience & Functional Tools demonstration.Alternatives to Psychiatric Residential Treatment Facilities Demonstration.Balancing Long Term Services & Supports.Person-Centered Hospital Discharge Model.Vision and Hearing Screening Services for Children and Adolescents.Early and Periodic Screening, Diagnostic, and Treatment.State Planning Grants for Qualifying Community-Based Mobile Crisis Intervention Services.SUPPORT Act Provider Capacity Demonstration.SUPPORT Act Innovative State Initiatives and Strategies.Medicaid Eligibility & Enrollment Toolkit.Medicaid Enterprise Certification Toolkit.Medicaid Information Technology Architecture.Section 223 Demonstration Program to Improve Community Mental Health Services.Actuarial Report on the Financial Outlook for Medicaid.CMS-64 FFCRA Increased FMAP Expenditure Data.State Budget & Expenditure Reporting for Medicaid and CHIP.Medicaid Eligibility Quality Control Program.Medicaid Third Party Liability & Coordination of Benefits.Seniors & Medicare and Medicaid Enrollees.Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations.1115 Substance Use Disorder Demonstrations.1115 Demonstration Monitoring & Evaluation.Medicaid & CHIP Marketplace Interactions.Performance Indicator Technical Assistance.Medicaid Enrollment Data Collected Through MBES.February 2023 Medicaid & CHIP Enrollment Data Highlights.Home & Community Based Services Authorities.Lawfully Residing Immigrant Children & Pregnant Individuals. ![]() Medicaid and CHIP Quality Resource Library.Affordable Care Act Program Integrity Provisions.Medicaid and CHIP Eligibility & Enrollment Webinars.Unwinding and Returning to Regular Operations after COVID-19.Home & Community-Based Services in Public Health Emergencies.Using Section 1115 Demonstrations for Disaster Response.Medicaid Data Collection Tool (MDCT) Portal.Eligibility & Administration SPA Implementation Guides.Health Home Information Resource Center.Promoting Community Integration Through Long-Term Services and Supports.Improving Care for Medicaid Beneficiaries with Complex Care Needs and High Costs.
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