MedicaidReimbursementHigh impact
March 2026 Medicaid Information Bulletin
Utah Medicaid·UT · Endocrinology, Dentistry, OB-GYN +3 more·Government Programs
Effective date
Mar 1, 2026
We identified it
Jun 21, 2026
Summary
Utah Medicaid announces multiple changes effective March 1, 2026, including enhanced DPP reimbursement (250% increase for first sessions using CPT 0403T/0488T with SW modifier), updated revenue codes, and transition of dental services for certain populations from managed care to fee-for-service in July 2026. New doula services will be covered starting April 1, 2026.
Action Required
By March 1, 2026: Update billing system to apply SW modifier to CPT codes 0403T (group) and 0488T (individual) for first DPP session claims to receive 250% reimbursement increase. Review and update revenue code configurations per PRISM Coverage download. By July 1, 2026: Transition dental billing for pregnant, postpartum, and EPSDT members from MCE plans to Medicaid FFS and ensure UUSOD network enrollment for reimbursement. By April 2026: Prepare for PRISM system migration from ForgeRock to Identity Cloud.