Orthodontic Services Statement of Coverage (effective 11/23/2022)
Alaska Medicaid and Denali KidCare cover orthodontic services performed by an orthodontist, and all orthodontic services, including limited, interceptive and comprehensive treatment, must be prior authorized. Orthodontic services are restricted to recipients aged 20 years and younger, with treatment expected to be completed before the recipient turns 21, and interceptive treatment is limited to individuals up to 13 years of age. Comprehensive treatment requires a Handicapping Labiolingual Deviation (HLD) score of 28 or greater, or additional medical information if the score is less than 28, and the total maximum allowable reimbursement for comprehensive treatment is $5,544.00.