MedicaidPrior AuthMedium impact
Adult Coverage of Current Dental Terminology (CDT) D4910 - Periodontal Maintenance Procedure
Illinois Medicaid - HFS·IL · Dentistry·Provider Notice
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
Effective July 1, 2019, CDT Code D4910 (Periodontal Maintenance Procedure) is now covered for adults ages 21 and older, previously only available for children through age 20. Providers must use D4910 instead of D1110 for periodontal maintenance and obtain prior authorization with supporting documentation.
Action Required
Immediately: Billing team must update system to use D4910 instead of D1110 for periodontal maintenance procedures in adults 21+. Configure prior authorization requirement for D4910 with pre-operative X-rays and periodontal charting documentation. Update encounter forms to reflect code change and prior auth requirement. Set billing rules to allow either D4910 or D1110 only once every 12 months per patient.