MedicaidCoverageHigh impact
Treatment of Temporomandibular Joint Disorders (for Indiana Only)
UnitedHealthcare·IN · Dentistry, Oral & Maxillofacial Surgery, ENT (Ear, Nose & Throat) +1 more·Medical Policy
Effective date
Dec 1, 2026
We identified it
Oct 3, 2026
Summary
UnitedHealthcare Community Plan of Indiana is removing coverage for four CPT codes (21060, 21247, 29800, 29804) related to temporomandibular joint disorder treatment, effective December 1, 2026. Indiana Medicaid providers must stop billing these codes and identify alternative treatment pathways for affected patients.
Action Required
By November 30, 2026: Billing team must update billing system to block submission of CPT codes 21060, 21247, 29800, and 29804 for Indiana Medicaid (UnitedHealthcare Community Plan) claims. Update claim denial logic to reference this policy change. Immediately notify providers and clinical staff that these TMJ codes are no longer reimbursable. Review any pending or scheduled procedures using these codes and contact patients and providers before December 1, 2026 to discuss alternative treatment options or obtain prior authorization if available under different coding pathways. Failure to comply will result in claim denials and patient balance issues.