MedicaidCoverageHigh impact
Change in Adult Dental Benefits
Illinois Medicaid - HFS·IL · Dentistry, Oral & Maxillofacial Surgery·Provider Notice
Effective date
Jul 1, 2012
We identified it
Jun 20, 2026
Summary
Starting July 1, 2012, Illinois Medicaid adult dental benefits are restricted to emergency procedures only, covering only evaluations, X-rays, extractions, and sedation when performed together with an extraction on the same date of service. All other adult dental services including routine cleanings, fillings, crowns, and dentures are no longer covered.
Action Required
By July 1, 2012: Billing team must update system to only allow adult dental codes D0140, D0220, D0230, D0330, D7140, D7210, D9230, and D9248 for Illinois Medicaid patients age 21+, and ensure exams, X-rays, and sedation are only billed when performed same day as extraction. Stop billing all other dental procedures for adults. Complete any multi-step authorized procedures by August 31, 2012 or claims will be denied.