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Update in Adult Dental Program Services

Illinois Medicaid - HFS·IL · Dentistry·Provider Notice
Effective date
Jul 1, 2014
We identified it
Jun 20, 2026
Days to comply

Summary

Adult dental services are being restored to 2011 levels effective July 1, 2014, with additional preventive services available for pregnant women. Providers must write 'Pregnant' in Box 35 of ADA claim forms for pregnant women to receive coverage for five specific preventive dental procedures.

Action Required

Action needed
Immediately: Update billing procedures to write 'Pregnant' in the Remarks Field (Box 35) of 2006 ADA claim forms when billing codes D0120, D1110, D4341, D4342, or D4355 for pregnant women. Billing team must ensure this field is completed to receive coverage for these additional preventive services for pregnant patients.

Affected Billing Codes

D0120
D1110
D4341
D4342
D4355