MedicaidAdministrativeMedium impact
MSA 18-38
Michigan Medicaid - MDHHS·MI · Dentistry·Provider Bulletin
Effective date
Nov 1, 2018
We identified it
Jun 20, 2026
Summary
Michigan Medicaid changed two dental policies: radiographs submitted with prior authorization requests will only be returned if providers check a box on form MSA-1680-B, and maxillary partial dentures no longer require six sound teeth for approval.
Action Required
By November 1, 2018: Dental providers must check field 17 on form MSA-1680-B if radiographs should be returned with PA requests. Update prior authorization workflows to assess maxillary partial denture candidates based on structural soundness and 5-year prognosis rather than requiring six sound teeth. Document beneficiary agreement with treatment plans in dental records.