MedicaidCoverageMedium impact
MAB2023092801
Pennsylvania Medicaid (DHS)·PA · Dentistry, Pediatrics·Provider Bulletin
Effective date
Oct 3, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Department of Human Services updated the Pediatric Dental Periodicity Schedule effective October 3, 2023, adding tobacco use and cessation counseling for children ages 6-21 and confirming that topical fluoride treatments are now covered up to age 21 (previously age 16). This provides updated preventive care guidelines for Medical Assistance pediatric dental services.
Action Required
By October 3, 2023: Dental providers should update their preventive care protocols to include tobacco use and cessation counseling for Medical Assistance patients ages 6-21, and ensure billing systems reflect that topical fluoride treatments (codes D1206 and D1208) are covered for patients up to age 21. Review the updated Pediatric Dental Periodicity Schedule to align preventive care recommendations with new guidelines.