Attention Provider Type 22 (Dental): Expanded Coverage for Adults 21 Years and Older (Updated July 2, 2026)

By July 1, 2026: (1) Billing team must update billing system to apply $1,000 annual per-calendar-year limit to all 39 listed dental procedure codes for Nevada Medicaid members age 21+. (2) Configure system to generate error code 5751 when claims for these codes exceed $1,000 in a calendar year and to communicate member financial responsibility per Provider Type 22 Billing Guide. (3) Ensure claims for emergency and palliative care (D9110, D9210, etc.) bypass the $1,000 limit. (4) Update claim scrubbing logic to track year-to-date spending by member for these codes. (5) Front desk/scheduling staff must be trained to inform members of the $1,000 annual limit and reset dates (January 1). (6) Print and post the attached flyer in clinical areas to encourage members to use benefits before annual limit exhaustion. (7) Dentists must be informed that endodontics and non-emergency extractions remain non-covered. Failure to enforce the $1,000 limit will result in claim denials or member balance issues.