MedicaidPrior AuthMedium impact
BT202397: IHCP announces dental coverage policy changes
Indiana Medicaid (IHCP)·IN · Dentistry·Medical Policy
Effective date
Sep 15, 2023
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) is implementing multiple dental coverage changes effective September 15, 2023, including expanding behavior management services to members with developmental disabilities, requiring prior authorization for all denture patients (including under 21), and updating fluoride treatment age limits and risk criteria.
Action Required
By September 15, 2023: Billing team must update prior authorization requirements for ALL denture patients regardless of age (complete and partial dentures). Update billing system to allow D9920 behavior management for members with developmental disabilities or mental illness, not just under 21. Remove D1355 from available codes and use D1354 for silver diamine fluoride with 3-month per tooth restrictions. Update age range for D1206 fluoride treatment to include infants (age 0-20) without caries risk requirements.