MedicaidAdministrativeMedium impact
Dental Encounters
Illinois Medicaid - HFS·IL · Dentistry·Provider Notice
Effective date
Aug 1, 2017
We identified it
Jun 20, 2026
Summary
This policy clarifies that dental encounters at FQHCs, ERCs, and RHCs require a face-to-face visit with a dentist to be billable, even when other qualified professionals provide services under supervision. All dental encounter claims must be submitted to DentaQuest, the state's dental contractor.
Action Required
Immediately: Billing team must ensure all dental encounter claims are submitted to DentaQuest instead of standard Medicaid processing. Verify that each dental encounter includes face-to-face dentist contact on the same day as services by other dental professionals. Update billing workflows to route dental encounters to DentaQuest contractor. Contact DentaQuest Provider Representative at 877-782-5565 for billing guidance.