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TMPPM Will Be Updated to Clarify Dental Informed Consent and Treatment Plan Requirements for Deep Sedation or General Anesthesia
Effective date
Dec 1, 2026
Identified
Nov 6, 2026
Summary
Texas Medicaid (TMHP) will update the TMPPM Children's Services Handbook section 3.2.8 effective December 1, 2026 to clarify dental informed consent and treatment plan documentation for services under deep sedation or general anesthesia. When a full dental exam or diagnostic imaging cannot reasonably be done beforehand, the provider must document the clinical circumstances, still obtain written informed consent describing the anticipated evaluation and possible treatment scope, and identify and document tooth and surface IDs as soon as they can be determined.
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What to do
Action · 6 steps
01By 2026-12-01: Dental billing staff and providers who perform dental services under deep sedation or general anesthesia for Texas Medicaid clients should update their informed consent forms and treatment plan templates so consent identifies tooth and surface IDs when reasonably determinable, and includes the anticipated evaluation, possible treatment types and scope, and risks, benefits and alternatives when a full exam or imaging cannot be done beforehand.
02Providers should document the clinical circumstances (age, disability, medical condition, inability to cooperate) that prevent pre-treatment identification, and record tooth and surface IDs promptly once determined.
03Front desk and clinical staff should be told that consent must be obtained before treatment and that consent does not extend beyond the scope obtained.
04Check claim documentation files so records support services billed, and watch for any further TMHP notice.
05Note that this notice is dated 2026-11-05 and its effective date is 2026-12-01, which is after the 2026-11-06 analysis date, so it is a future change.
06For Medicaid managed care members, confirm each MCO's own documentation or authorization requirements.
Original notice
TMPPM Will Be Updated to Clarify Dental Informed Consent and Treatment Plan Requirements for Deep Sedation or General Anesthesia
tmhp.com · Always check the source before changing claims.