Section 16.03.09.803 - DENTAL SERVICES: COVERAGE AND LIMITATIONSSome covered dental services may be subject to limitations, authorization from the Idaho Smiles contractor or benefit restrictions according to the terms of its contract with the Department, in addition to those specified in these rules.
01.Dental Coverage for Children. Children are covered for dental services that include preventative screenings, problem-focused and comprehensive exams, diagnostic, restorative, endodontic services (including root canals and crowns), periodontics, prosthodontic, orthodontic treatments, dentures, and oral surgery;02.Dental Limitation for Children. Orthodontics are limited to children who meet Medicaid eligibility requirements and the Idaho Medicaid Handicapping Malocclusion Index as determined by the State's contractor.03.Dental Coverage for Adults. Adults are covered for dental services that include preventative screenings, problem-focused and comprehensive exams, diagnostic, restorative, periodontics, prosthodontic, dentures, oral surgery, and endodontic services with limitations.04.Dental Limitation for Adults. Root canals and crowns are not covered.Idaho Admin. Code r. 16.03.09.803