Statutes, codes, and regulations
Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICESArticle 5 - MEDICAID SERVICES
Rule 405 IAC 5-14 - Dental Services
Section 405 IAC 5-14-1 - Policy

405 Ind. Admin. Code 5-14-1

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Current through November 6, 2024
Section 405 IAC 5-14-1 - Policy

Authority: IC 12-15

Affected: IC 12-13-7-3; IC 12-15

Sec. 1.

(a) Medicaid reimbursement is available only for those dental services listed in section 2 of this rule subject to the limitations set out in this rule.
(b) For those members twenty-one (21) years of age and over, all covered services will require prior authorization except the following:
(1) Diagnostic and preventative services.
(2) Direct restorations.
(3) Treatment of lesions.
(4) Periodontal services for the following immuno-compromised individuals:
(A) Transplant patients.
(B) Pregnant women.
(C) Diabetic patients.
(5) Extractions.
(6) Emergency and trauma care.

405 IAC 5-14-1

Office ofthe Secretary of Family and Social Services; 405 IAC 5-14-1; filed Jul 25, 1997, 4:00p.m.: 20 IR 3319; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; filed Dec 13, 2002, 4:00 p.m.: 26 IR 1546; filed Aug 17, 2007, 3:23 p.m.: 20070912-IR-405060005FRA; readopted filed Sep 19, 2007,12:16p.m.: 20071010-IR-405070311RFA; filedMay 9, 2011, 4:01 p.m.: 20110608-IR-405100795FRA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA
Filed 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRA
Filed 9/2/2016, 12:26 p.m.: 20160928-IR-405150450FRA
Readopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFA
Readopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA