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SPA 19-0010 Dental and Orthodontic Reimbursement approved by CMS

State Plan Amendment (SPA) 19-0010 Dental and Orthodontic Reimbursement has been approved by the Centers for Medicare and Medicaid Services (CMS), effective March 1, 2019, to allow the Division of Medicaid to:

1. Revise the reimbursement methodology for dental and orthodontic services as the lesser of: a) The provider’s usual and customary charge, b) A fee from the Mississippi Medicaid statewide uniform dental fee schedule in effect July 1, 2018, or c) The fiftieth (50th) percentile fee reflected in the 2019 National Dental Advisory Service (NDAS) Fee Report.

2. Remove language excluding dental services for: a) Pregnant women as required by the Affordable Care Act (ACA), and b) Beneficiaries enrolled in the Healthier Mississippi Waiver (HMW) as required by the 2014 waiver renewal.

For more information read the approved SPA pages.