MedicaidPrior AuthMedium impact
MSA 21-44
Michigan Medicaid - MDHHS·MI · Dentistry, Oral & Maxillofacial Surgery·Provider Bulletin
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Michigan Medicaid no longer requires radiographs to be submitted with prior authorization requests for partial dentures, effective January 1, 2022. Dentists must instead provide detailed information in the Other Pertinent Dental or Medical History section of form MSA-1680-B to document occlusion and medical information.
Action Required
Immediately for Michigan Medicaid providers: Stop submitting radiographs with prior authorization requests for partial dentures. Update workflow to include detailed documentation in the Other Pertinent Dental or Medical History section of form MSA-1680-B instead of radiographs. Ensure all documentation and tooth charting is complete and accurate before submitting PA requests.