MedicaidCoverageHigh impact
Dental Billing Tips
Missouri Medicaid (MO HealthNet)·MO · Dentistry·Provider Notice
Effective date
Jan 4, 2017
We identified it
Jun 20, 2026
Summary
This MO HealthNet policy provides updated dental billing guidance for Medicaid patients, specifying which dental codes are covered under the Adult Dental Limited Package versus requiring medical necessity documentation. Key changes include coverage limitations for certain oral evaluations, X-rays, and sedation codes, with specific prior authorization requirements for periodontal procedures.
Action Required
Immediately: Billing team must update dental billing procedures for MO HealthNet patients. Obtain letters of medical necessity from primary care providers for D0120 codes. Limit D0230 codes to 4 per date of service and D0240 to 1 per date. Require prior authorization for D4341 and D4342 periodontal procedures with periodontal charting submission. Update billing system to flag these requirements and ensure adequate documentation exists before billing any dental services.