MedicaidBilling CodesMedium impact
Dental Encounters
Illinois Medicaid - HFS·IL · Dentistry·Provider Notice
Effective date
Aug 1, 2017
We identified it
Jun 20, 2026
Summary
Dental encounters at FQHCs, ERCs, and RHCs can only be billed as encounters if the patient has a face-to-face visit with a dentist on that day. Services provided by other qualified professionals under dentist supervision cannot be billed as dental encounters unless the dentist also sees the patient face-to-face during the same visit.
Action Required
Immediately: Billing teams at FQHCs, ERCs, and RHCs must verify that all dental encounter claims include face-to-face dentist visits on the same day as services. Submit all dental encounter claims to DentaQuest contractor instead of standard Medicaid processing. Review current billing practices to ensure compliance - services by other professionals under dentist supervision cannot be billed as encounters without same-day dentist face-to-face visit.