TO: Dentists and Oral Surgeons
RE: COVID-19 Unwinding-Changes and Updates to Dental Services
Per federal guidance, the COVID-19 public health emergency (PHE) will end on May 11, 2023.
Therefore, some flexibilities the Alabama Medicaid Agency (Medicaid) implemented due to the COVID-19 PHE will end at this time. Medicaid intends to keep providers updated on changes that will be
forthcoming during the return to normal operations. Medicaid is working with the Centers for Medicare
and Medicaid Services (CMS) to prepare to end some flexibilities implemented during the COVID-19
PHE. Notice of changes will be provided through additional notices via State Plan notice, Administrative
Code notice, waiver notice, or Provider ALERTs.
Effective 5/12/23:
- Medicaid will discontinue the $20 PPE reimbursement.
- Medicaid will cover 3 units of D0140 (emergency dental treatment) per calendar year per
recipient per provider/provider group.
Reimbursement Increase
Effective June 1, 2023, Medicaid will increase the reimbursement for the following procedure codes. An
updated Dental services fee schedule will be posted by May 15, 2023.
|
Procedure Code
|
Procedure Code Description
|
Rate as of 6/1/23
|
|
Procedure Code
|
Procedure Code Description
|
Rate as of 6/1/23
|
|
D0120
|
PERIODIC
ORAL EVALUATION
|
$20.00
|
|
D3320
|
END
THXPY, PREMOLAR TOOTH
|
$554.40
|
|
D0150
|
COMPREHENSVE
ORAL EVALUATION
|
$32.80
|
|
D3330
|
END
THXPY, MOLAR TOOTH
|
$660.00
|
|
D0330
|
PANORAMIC
IMAGE
|
$52.80
|
|
D3351
|
APEXIFICATION/RECALC
INITIAL
|
$184.80
|
|
D1110
|
DENTAL
PROPHYLAXIS ADULT
|
$40.00
|
|
D3410
|
APICOECTOMY
- ANTERIOR
|
$327.20
|
|
D1354
|
INT
CARIES MED APP PER TOOTH
|
$40.00
|
|
D4355
|
FULL
MOUTH DEBRIDEMENT
|
$73.60
|
|
D1520
|
REMOVE
UNILAT SPACE MAINTAIN
|
$157.60
|
|
D4910
|
PERIODONTAL
MAINT PROCEDURES
|
$66.40
|
|
D1526
|
REMOVE
BILAT SPACE MAIN, MAX
|
$243.20
|
|
D5110
|
DENTURES
COMPLETE MAXILLARY
|
$624.00
|
|
D1527
|
REMOVE
BILAT SPACE MAIN, MAN
|
$243.20
|
|
D5120
|
DENTURES
COMPLETE MANDIBLE
|
$624.00
|
|
D2140
|
AMALGAM
ONE SURFACE PERMANEN
|
$53.60
|
|
D6240
|
BRIDGE
PORCELAIN HIGH NOBLE
|
$493.60
|
|
D2150
|
AMALGAM
TWO SURFACES PERMANE
|
$66.40
|
|
D6245
|
BRIDGE
PORCELAIN/CERAMIC
|
$537.60
|
|
D2161
|
AMALGAM
4 OR > SURFACES PERM
|
$92.00
|
|
D6740
|
CROWN
PORCELAIN/CERAMIC
|
$537.60
|
|
D2332
|
RESIN
THREE SURFACES-ANTERIO
|
$93.60
|
|
D6750
|
CROWN
PORCELAIN HIGH NOBLE
|
$509.60
|
|
D2335
|
RESIN
4/> SURF OR W INCIS AN
|
$110.40
|
|
D7140
|
EXTRACTION
ERUPTED TOOTH/EXR
|
$64.00
|
|
D2391
|
POST
1 SRFC RESINBASED CMPST
|
$76.00
|
|
D7210
|
REM
IMP TOOTH W MUCOPER FLP
|
$109.60
|
|
D2392
|
POST
2 SRFC RESINBASED CMPST
|
$91.20
|
|
D7241
|
IMPACT
TOOTH REM BONY W/COMP
|
$269.60
|
|
D2393
|
POST
3 SRFC RESINBASED CMPST
|
$113.60
|
|
D7250
|
TOOTH
ROOT REMOVAL
|
$115.20
|
|
D2394
|
POST
>=4SRFC RESINBASE CMPST
|
$138.40
|
|
D7280
|
EXPOSURE
OF UNERUPTED TOOTH
|
$199.20
|
|
D2740
|
CROWN
PORCELAIN/CERAMIC
|
$537.60
|
|
D7285
|
BIOPSY
OF ORAL TISSUE HARD
|
$398.40
|
|
D2750
|
CROWN
PORCELAIN W/ H NOBLE M
|
$511.20
|
|
D7286
|
BIOPSY
OF ORAL TISSUE SOFT
|
$170.40
|
|
D2751
|
CROWN
PORCELAIN FUSED BASE M
|
$469.60
|
|
D7471
|
REM
EXOSTOSIS ANY SITE
|
$422.40
|
|
D2752
|
CROWN
PORCELAIN W/ NOBLE MET
|
$480.80
|
|
D7520
|
I&D
ABSCESS EXTRAORAL
|
$56.00
|
|
D2792
|
CROWN
FULL CAST NOBLE METAL
|
$469.60
|
|
D7911
|
DENTAL
SUTURE WOUND TO 5 CM
|
$465.60
|
|
D2931
|
PREFAB
STNLSS STEEL CROWN PE
|
$127.20
|
|
D7971
|
EXCISION
PERICORONAL GINGIVA
|
$84.80
|
|
D2932
|
PREFABRICATED
RESIN CROWN
|
$136.00
|
|
D9222
|
DEEP
ANEST, 1ST 15 MIN
|
$160.00
|
|
D2952
|
POST
AND CORE CAST + CROWN
|
$170.40
|
|
D9223
|
GENERAL
ANESTH EA ADDL 15 MI
|
$120.00
|
|
D3110
|
PULP
CAP DIRECT
|
$33.60
|
|
D9230
|
ANALGESIA
|
$27.20
|
|
D3120
|
PULP
CAP INDIRECT
|
$27.20
|
|
D9243
|
IV
SEDATION EA ADDL 15M
|
$93.60
|
|
D3310
|
END
THXPY, ANTERIOR TOOTH
|
$477.60
|
|
D9310
|
DENTAL
CONSULTATION
|
$80.80
|
New Dental Program Team
The Current Procedural Terminology (CPT) and Current Dental Terminology
(CDT) codes descriptors, and other data are copyright © 2023 American
Medical Association and © 2023 American Dental Association (or such other date publication of CPT and
CDT). All rights reserved. Applicable FARS/DFARS apply.