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TO:   All Providers

RE:   Dental Coverage for Pregnant Adults

Effective October 1, 2022, Alabama Medicaid will reimburse for dental services rendered to pregnant adults who are ages 21 and older during pregnancy, and during postpartum in accordance with 42 CFR § 440.210(a)(3), when the services are rendered by Alabama Medicaid enrolled dental providers. Services will not change for individuals under age 21. To be reimbursed for these services, dental providers must:

1.     Verify the recipient’s eligibility. Documentation to support the completion of verification must be kept in the recipient’s medical record.

2.     Obtain an attestation from the recipient that she is pregnant or postpartum. The attestation must include the recipient’s signature and date signed and must include an end of pregnancy date, if postpartum. Documentation to support the attestation must be kept in the recipient’s medical record. 

3.     Render the service(s).

4.     Append D9999 to the claim when billing for these services. Without this code, the claim will not pay.

5.     Submit the claim.

Failure to provide the required support documentation related to these rendered services may result in recoupment.

Please plan to attend a provider webinar on September 22, 2022 at 12:00 p.m.: “Postpartum Extension, Dental Coverage, & Other Changes” https://medicaid.alabama.gov/news_detail.aspx?ID=15941.

A list of frequently asked questions is available on the Dental Program webpage:  https://medicaid.alabama.gov/content/4.0_Programs/4.2_Medical_Services/4.2.2_Dental.aspx.

Providers with billing questions should contact the Gainwell Technologies Provider Assistance Center at 1-800-688-7989.

The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2022 American Medical Association and © 2022 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.