MedicaidBilling CodesMedium impact
Supplement 24-21: Dental Procedure Code (D1354) – Application of Silver Diamine Fluoride Provided by Dental Providers
New Mexico Medicaid·NM · Dentistry·Claims & Billing
Effective date
Oct 1, 2024
We identified it
Jun 21, 2026
Summary
New Mexico Medicaid now covers dental procedure code D1354 (Silver Diamine Fluoride application) for caries treatment, effective October 1, 2024. The policy allows up to 2 treatments per tooth per year, maximum 5 teeth per session, with specific eligibility requirements including comprehensive dental examination documentation.
Action Required
Immediately: Dental providers must update billing systems to include procedure code D1354 for Silver Diamine Fluoride treatment. Document comprehensive dental examination and tooth numbers in patient records. Bill on ADA Dental Claim forms following maximum limits of 2 treatments per tooth per 12 months and 5 teeth per session. FQHCs must use D0999 for payment and list D1354 with tooth numbers. Indian Health Services providers use UB04 with revenue code 0512 and append D1354.