MedicaidCoverageMedium impact
Supplement 24-20: Silver Diamine Fluoride (0792T) by a Physician or Other Qualified Health Care Professional
New Mexico Medicaid·NM · Family Medicine, General Practice, Pediatrics +1 more·Medical Policy
Effective date
Oct 1, 2024
We identified it
Jun 21, 2026
Summary
New Mexico Medicaid now covers silver diamine fluoride (SDF) applications using code 0792T when performed by physicians or other qualified healthcare professionals (not dentists). This provides a new billing opportunity for medical providers treating tooth decay, with coverage effective October 1, 2024.
Action Required
Immediately: Medical providers (physicians, nurse practitioners, physician assistants) can begin billing code 0792T for silver diamine fluoride applications to New Mexico Medicaid patients. Update billing software to include code 0792T with proper documentation requirements. Ensure clinical evidence of caries is documented in medical records. Maximum 2 treatments per tooth per 12 months, up to 5 teeth per session. No prior authorization required.