Comprehensive Dental Care for Adults with Developmental or Intellectual Disabilities Residing in an Intermediate Care Facility (IB 23-7)
Date: 05/01/23
Louisiana Healthcare Connections is sharing with providers a recent publication providing coverage of Comprehensive Dental Care for Adults with Developmental or Intellectual Disabilities Residing in an Intermediate Care Facility issued on April 27, 2023.
Coverage details include:
Act 366 of the 2022 Regular Session was signed into law by Gov. John Bel Edwards on June 10, 2022. The Act provides for the coverage of comprehensive dental care for adults 21 years of age and older with developmental or intellectual disabilities who reside in an intermediate care facility (ICF). Coverage will begin on May 1, 2023.
Some diagnostic services, such as exams and some radiographic images, will be provided by the ICF. These services include D0120, D0150, D0210, D0240, D0272 and D0330. Providers should bill these services to the ICF.
The following services should be billed to the beneficiary’s assigned Dental Benefit Plan Manager (DBPM):
- Diagnostic services (excluding the codes listed above)
- Preventive services
- Restorative services
- Endodontics
- Periodontics
- Prosthodontics
- Oral and maxillofacial surgery
- Orthodontics
- Emergency care
DBPM Provider Manuals and the Medicaid DBPM Manual are being updated to include benefit information.
Questions regarding claims should be directed to the appropriate DBPM:
- DentaQuest Provider Relations: 1-800-508-6785
- MCNA Dental Provider Relations: 1-855-701-6262