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mab2025091101

Pennsylvania Medicaid (DHS)·PA · Dentistry, Oral & Maxillofacial Surgery·Provider Bulletin
Effective date
Aug 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medical Assistance updated their dental fee schedule with significant changes to age limits, frequency limitations, and unit limits for multiple dental procedure codes. Key changes include reducing age limits for wisdom tooth extractions from 23 to 22 years, changing most restorative procedures from daily limits to 180-day limits, and making many endodontic procedures lifetime-limited instead of daily-limited.

Action Required

Action needed
Immediately: Billing team must update Pennsylvania Medicaid dental billing rules to reflect new age limits (D7280/D7283 now limited to ages 0-22), frequency limitations (most restorative procedures now limited to once per 180 days instead of daily), and unit limits (most procedures now limited to 1 unit per claim). Update billing software to enforce new frequency limits and age restrictions. Review denied claims since August 1, 2025 for rebilling opportunities under new rules.

Affected Billing Codes

D7280
D7283
D1553
D1556
D1516
D1517
D0340
D1551
D1552
D1557
D1558
D2140
D2150
D2160
D2161
D2330
D2331
D2332
D2335
D2390
D2391
D2392
D2393
D2394
D2910
D2915
D2920
D2930
D2931
D2932
D2933
D2934
D2952
D2954
D2980
D3220
D3230
D3240
D3310
D3320
D3330
D3410
D3421
D3425
D3426
D3471
D3472
D3473
D3501
D3502
D3503
D3921
D5410
D5411
D5421
D5422
D5511
D5512
D5520
D5611
D5612
D5621
D5622
D5630
D5640
D5650
D5660
D6930
D6980
D7260
D7270
D7310
D7320
D7471
D7472
D7473
D7485
D7961
D7970
D9948
D9949
D9953
D1510
D4210
D4341
D4342
D7230
T1015