MedicaidReimbursementHigh impact
Provider Letter 2026-12: Re: D1354 Reimbursement Rate Update
Oklahoma SoonerCare·OK · Dentistry·Reimbursement
Effective date
Aug 1, 2026
We identified it
Jul 15, 2026
Summary
Oklahoma Health Care Authority (OHCA) is reducing reimbursement rates for dental code D1354 (interim caries arresting medicament application) effective August 1, 2026. Rates are decreasing from $76.22 to $18.29 for children and from $83.93 to $20.14 for adults—a 76% reduction. Billing teams must update fee schedules and claims processing systems immediately to avoid payment delays and claim denials.
Action Required
By July 31, 2026: Billing team must update all claims processing and billing software to reflect new D1354 reimbursement rates ($18.29 for children, $20.14 for adults). Update fee schedules in the billing system, encounter forms, and any automated claim submission tools. Notify all dental providers in the practice of the rate change and document the effective date. Any claims for D1354 submitted on or after August 1, 2026 using old rates will be denied or subject to recoupment. Contact OHCA Dental Unit at 405-522-7401 with questions or if system updates cannot be completed by the deadline.