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Indiana Medicaid (IHCP)Medicaid · Coverage · Medical Policy · IN · DentistryMedium impact

BT2024121: IHCP clarifies dental prophylaxis coverage

Act
immediately
Effective date
Aug 1, 2024
Identified
Jun 19, 2026

Summary

Indiana Health Coverage Programs (IHCP) corrected previously published inaccurate information about dental prophylaxis coverage limitations. The policy clarifies age-based frequency limits for prophylaxis services (D1110 and D1120) for members without periodontal disease.

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What to do

immediately · 2 steps
01Billing team must update dental prophylaxis billing practices for IHCP members to follow corrected frequency limitations - no coverage under 12 months unless medically necessary, every 6 months for ages 12 months-20 years, every 12 months for ages 21+, and every 6 months for institutionalized members.
02Review and update billing system rules for D1110 and D1120 codes.

Codes mentioned

D1110D1120

Original notice

BT2024121: IHCP clarifies dental prophylaxis coverage
in.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Indiana Medicaid (IHCP) changes →
BT202397: IHCP announces dental coverage policy changesMediumEffective Sep 15, 2023 · Medical PolicyBrowse every Indiana Medicaid (IHCP) change in the policy list

Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesDentistryCode D1110Code D1120

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