MedicaidCoverageMedium impact
Dental Benefit Limitations Amended
Illinois Medicaid - HFS·IL · Dentistry·Provider Notice
Effective date
May 1, 2021
We identified it
Jun 20, 2026
Summary
Illinois is temporarily expanding dental benefit limitations for children ages 0-20 during the COVID-19 emergency, allowing additional dental services in school settings alongside office visits. The changes affect periodic exams, cleanings, fluoride treatments, and sealants with modified frequency limits starting May 1, 2021.
Action Required
By May 1, 2021: Billing teams at dental practices in Illinois must update their systems to allow additional frequency limits for pediatric dental codes D0120, D1120, D1206, D1208, and D1351. Update billing software to permit school-based services in addition to office visits for the same 6-month periods. Verify patient eligibility includes both fee-for-service Medicaid and HealthChoice Illinois managed care plans.