MedicaidBilling CodesHigh impact
BT202187: FQHC/RHC wraparound supplemental dental claim processing change
Indiana Medicaid (IHCP)·IN · Dentistry·Claims & Billing
Effective date
Sep 29, 2021
We identified it
Jun 19, 2026
Summary
Starting September 29, 2021, FQHC and RHC dental wraparound payments will be processed automatically by Gainwell Technologies on a claim-by-claim basis instead of through monthly settlements with Myers and Stauffer. Providers must bill code D9999 (limited to one unit per day) for dental encounters and can now use additional place of service codes including telehealth (02), school (03), and homeless shelter (04).
Action Required
Immediately for DOS on or after July 1, 2021: FQHC/RHC billing teams must update procedures to bill exactly one unit of code D9999 for dental encounters (system will automatically reduce multiple units to one with EOB 9916). Stop submitting dental wraparound claims to Myers and Stauffer - these will now be processed automatically by Gainwell. Update billing system to accept new place of service codes 02 (telehealth), 03 (school), and 04 (homeless shelter) for FQHC/RHC encounters. Monitor remittance advice for new EOB codes 3370, 3372, 4121, 4124, 4173, 6096, and 9916 to identify claim issues.