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Illinois Medicaid - HFSMedicaid · Billing Codes · Provider Notice · IL · Dentistry, Oral & Maxillofacial SurgeryHigh impact

Dental Office Reference Manual – Reissue; Exhibits A-C Dental Benefits Covered Coding Updates

Act
immediately
Effective date
Not stated in the notice
Identified
Sep 5, 2026

Summary

Illinois Department of Financial and Professional Regulation has reissued the Dental Office Reference Manual (DORM) with updates to dental benefits covered coding. Providers must review the updated DORM and Exhibits A-C for coding changes to ensure accurate billing and payment from the Department.

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What to do

immediately · 5 steps
01Billing team and providers must obtain and review the full updated Dental Office Reference Manual (DORM) and Exhibits A-C Dental Benefits Covered document from the Illinois Department of Financial and Professional Regulation.
02Identify all coding changes in the Revision History section.
03Update billing software, encounter forms, and internal coding references to reflect the new covered coding requirements.
04Coordinate with all enrolled dentists and dental providers to ensure compliance.
05Contact the Bureau of Professional and Ancillary Services at 877-782-5565 with questions about specific coding changes.
If missed: Failure to implement updated coding may result in claim denials or payment delays.

Original notice

Dental Office Reference Manual – Reissue; Exhibits A-C Dental Benefits Covered Coding Updates
hfs.illinois.gov · Always check the source before changing claims.
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Related changes

See all Illinois Medicaid - HFS changes →
Dental Office Reference Manual – Re-issueMediumEffective Jun 5, 2020 · Provider NoticeDental Office Reference Manual - ReissueMediumEffective Nov 8, 2021 · Provider NoticeDental Office Reference Manual - ReissueMediumEffective Aug 23, 2024 · Provider NoticeDental Office Reference Manual - ReissueMediumEffective Apr 28, 2025 · Provider NoticeBrowse every Illinois Medicaid - HFS change in the policy list

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Illinois Medicaid - HFS policiesIL policy changesDentistryOral & Maxillofacial Surgery

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