Ohio Department of Medicaid Adopts New Codes to Increase Access to Dental Care

Effective January 1, 2025:

D9997 - Dental Case Management, Special Needs

Reimbursement for care to individuals with a disability who require additional time and resources during a dental visit.

Reimbursement: $150, Prior Authorization

Adoption of this code will allow dentists to receive reimbursement for the individualized, comprehensive care they provide to patients with a disability. This is significant because, previously, dentists were not compensated for the extra time and resources frequently required to care for these patients. The OSU Nisonger Center, in collaboration with Oral Health Ohio and the Ohio Association of Community Health Centers, were instrumental in advocating for this change.

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CPT 0792T - Application of Silver Diamine Fluoride (SDF) by Physician or Other Qualified Health Professional

Enables physicians or other qualified health professionals to apply Silver Diamine Fluoride, a non-invasive treatment to manage early tooth decay.  Learn more about SDF here.

Reimbursement: $29.48

Expanding access to SDF empowers physicians and other healthcare professionals to fight early tooth decay, bridging the gap in care while patients wait for dental appointments. This important step can help address the Medicaid dental provider shortage and underscores the critical need for medical-dental integrated care. Oral Health Ohio is thrilled to see this important advocacy initiative become a reality.

Read Medicaid Advisory Letter (MAL) >