MedicaidReimbursementMedium impact
Dental MCP Reimbursement at the All-Inclusive Rate for Tribal Health Programs
Medi-Cal·CA · Dentistry·Claims & Billing
Effective date
Jan 1, 2026
We identified it
May 3, 2026
Summary
Effective immediately and retroactively to January 1, 2026, Dental Managed Care Plans must reimburse IHS-MOA clinics and Tribal FQHCs at the All-Inclusive Rate (AIR) for covered dental services when Medi-Cal members are enrolled in a Dental MCP. Providers must bill the member's assigned Dental MCP directly for reimbursement at the AIR rate.
Action Required
Immediately: Billing team must verify Medi-Cal member enrollment in Dental MCPs before submitting claims. For members enrolled in Dental MCPs, submit dental service claims directly to the assigned Dental MCP for AIR reimbursement instead of Medi-Cal fee-for-service. Update billing workflows to separate medical and dental claims when both services are provided on the same day. Contact Dental MCP Tribal Liaisons for billing assistance when the liaison list becomes available.