Appropriation IDs - 15000 Global Commitment, 17000 State-Only, and 18000 Non-Waiver
Vermont Medicaid offers dental programs for both children (through Dr. Dynasaur) and adults. Dental coverage for children under Dr. Dynasaur is a robust benefit that includes the dental services necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions.
The Agency of Human Services (AHS) made the following changes to the Medicaid adult dental benefit effective January 1, 2020.
•Increased the annual maximum dollar limit on adult dental services from $510 to $1,000.
•Allowed up to two visits for preventive services per calendar year that do not count towards the $1000 annual maximum dollar limit and removing copayments from preventive dental services listed below, including D0120 Periodic Oral Exam.
These changes are a result of Act 72 enacted during the 2019 legislative session. The changes are intended to expand adult Medicaid beneficiaries’ access to dental care and encourage the utilization of preventive dental care. These changes apply to Medicaid beneficiaries age 21 and older, who are not pregnant or in the postpartum period.
Codes for preventive services outside of the annual maximum dollar amount include:
|D1110 Prophylaxis – Adult “cleaning”|
|D1206 Topical Fluoride Varnish|
|D1208 Topical Application of Fluoride|
|D1354 Silver Diamine Flouride|
|D1320 Tobacco Counseling for the Control and Prevention of Oral Disease|
|D0120 Periodic Oral Exam|
Vermont Medicaid beneficiaries