MedicaidCoverageMedium impact
Additions to Medicaid Coverage for Dental Services
Nebraska Medicaid·NE · Dentistry, Oral & Maxillofacial Surgery·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 21, 2026
Summary
Nebraska Medicaid has added coverage for diagnostic consultation (D9310) by dentists other than the requesting dentist, limited to once every 365 days, and third molar extractions when at least one molar has documented pathology. These changes are effective for services provided on or after July 1, 2025.
Action Required
Immediately: Billing team must update system to allow billing of D9310 for diagnostic consultations by dentists other than the requesting dentist, limited to once per 365 days. Add edit checks to prevent billing D9310 if another exam procedure is billed by the same dental practice on the same day. Update encounter forms to remind providers that third molar extractions require documented pathology for at least one molar.