Effective March 15, 2014 Mississippi Division of Medicaid (DOM) opened two Orthodontic service codes to streamline Phase I Prior Authorization (PA) requests. Phase I Orthodontic PA requests will no longer be approved in a lump sum.
- D8050 – Phase I Interceptive Orthodontic treatment of the primary detention
- D8060 – Phase I Interceptive Orthodontic treatment of the transitional detention
Please submit all Orthodontic PA requests to eQHealth Solutions by mail or via the eQSuite web portal for processing. If you need assistance accessing eQSuite, please contact eQ Health Solutions toll-free: (866) 740-2221. Effective Dec. 1, 2013 DOM PA forms were no longer accepted.
April 3, 2014
