MedicaidCoverageMedium impact
September 2025 Medicaid Information Bulletin
Utah Medicaid·UT · Dentistry, Psychiatry, Speech Therapy·Government Programs
Effective date
Sep 1, 2025
We identified it
Jun 21, 2026
Summary
Utah Medicaid has implemented multiple policy changes effective September 1, 2025, including new orthodontic treatment codes with specific age limits, changes to unlicensed behavioral health provider enrollment requirements, and updated policies for DME supplies, speech therapy, and court-ordered behavioral health services.
Action Required
By September 1, 2025: Billing teams must update systems to include new orthodontic codes D8070, D8080, D8090 with age restrictions (D8070: ages 10-14, D8080: ages 10-21, D8090: ages 14-21). Behavioral health providers must stop enrolling unlicensed providers in PRISM and instead bill under licensed supervisor's NPI with HL modifier. DME providers must update claim submission procedures to report actual service dates when shipping supplies early (between 25th-end of month) and include shipping/delivery dates in Additional Claim Information field.