AGENCY FOR HEALTH CARE ADMINISTRATION
RULE NO.:RULE TITLE:
59G-4.060Dental Services
NOTICE OF CHANGE
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 42 No. 10, January 15, 2016 issue of the Florida Administrative Register.
The following changes have been made to the Florida Medicaid Dental Services Coverage Policy.
Section 2.3 Coinsurance, Copayment, or Deductible, the bullet points are stricken and the first sentence now reads:
Recipients are responsible for a $3.00 copayment for non-emergency dental services, per federally qualified health center visit, per day, unless the recipient is exempt from copayment requirements or the copayment is waived by the Florida Medicaid managed care plan in which the recipient is enrolled.
Section 4.2.1.1 Office Visit – After Regularly Scheduled Hours, section stricken.
Section 4.2.2.2 Diagnostic Imaging, first bullet now reads:
Bitewing radiograph(s) every 181 days, per recipient under the age of 21 years
Section 5.2 Specific Non-Covered Criteria, fourth bullet now reads:
Individual periapical radiograph(s) on the same date of service when the reimbursement amount exceeds that of a complete series (D0210)
Section 6.2 Specific Criteria, now reads:
Fee-for-service providers must maintain a record of any behavior management services provided in the recipient file.
Section 7.2 Specific Criteria, first bullet now reads:
Orthodontic initial assessment
Section 8.4 Diagnosis Code, section stricken.
