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TO:   Dentists and Oral Surgeons

RE:   Dental Changes Related to COVID-19 Emergency

As Medicaid continues to monitor the outbreak of the Coronavirus Disease 2019 (COVID-19) in Alabama, we are extending policies for coverage of an additional dental code. We are also allowing other changes to policy as described below:

1.    Under the same guidelines as published in the March 18, 2020, ALERT, Medicaid approves code D0140, increasing the limit from 1 per recipient per provider/provider group per calendar year, to 3 per recipient per provider/provider group per calendar year. This increase applies to all approved places of service during the COVID-19 emergency.

2.    Medicaid will change the Provider Manual description for CDT code D1110 (13 years of age and older) and D1120 (3 years of age to 13 years) to match the following CDT description: Removal of plaque, calculus and stains from the tooth structures in the (either permanent or primary) dentition. The intent is to control local irritational factors. 

3.    Medicaid will provide for PPE reimbursement of $20 per patient visit using the American Dental Association (ADA) recommended CDT code D1999 (unspecified preventive procedure, by report) during the COVID-19 emergency. Restrictions are:    

a)    can only be filed for place of service 11 and 15

b)    can only be filed once per recipient per day of service

c)    must be filed with other dental treatment on the claim

The effective dates for this ALERT are March 16, 2020 – July 31, 2020, or at the conclusion of the COVID-19 national emergency, whichever occurs first. Providers can begin submitting claims on

July 14, 2020.

During the COVID-19 emergency, it is important to file claims as quickly as possible to ensure payment from Medicaid is made to Medicaid providers close to the date of service. The Centers for Medicare and Medicaid Services (CMS) has increased the federal matching percentage for the emergency time frame, but states can only receive the increased match on claims that are paid during the emergency. Providers should include appropriate COVID-19 diagnosis code(s) on claims submitted to help with tracking of COVID-19.

For questions regarding the Dental program, contact Dr. Danny Rush at (334) 242-5585 or danny.rush@medicaid.alabama.gov.