Medi-Cal is back at Dentalville!

Call Us Today:

(888) 633-6825

 
 
Starting January 1, 2018, Medi-Cal Dental coverage for all adults will be back at Dentalville! If eligible, your needed dental work will be at no cost to you!

Procedures now covered will include:

Procedure Full Scope Pregnancy Related
Oral Evaluation (Under age 3)*
Initial Exam (Age 3 and above)
Periodic Exam (Age 3 and above)
Prophylaxis
Fluoride
Restorative Services - Amalgams/Composites/Pre-fabricated Crowns
Labratory Processed Crowns**
Scaling and Root Planing***
Full Mouth Debridement
Periodontal Maintenance
Anterior Root Canals
Posterior Root Canals
Partial Dentures
Full Dentures
Extractions/Oral and Maxillofacial Surgery
Emergency Services
* ONLY a benefit under age 3
**
  1. Not a benefit under age 13
  2. Over age 21, allowable under special circumstances for posterior teeth
    1. A benefit only for the treatment of posterior teeth acting as an abutment for an existing removable partial denture with cast clasps and rest. OR
    2. When the treatment plan includes an abutment crown and removable partial denture (D5213 or D5214). Both shall be submitted on the same TAR for prior authorization
*** Not a benefit under age 13. Allowable under special circumstances

You can count on Dentalville to help you every step of the way, from enrollment to maximizing your new benefits. For more information, to check your eligibility and to schedule an appointment, call us now at (888) 633-6825. Appointments are filling up quickly!

There are no changes to the current scope of benefits for the following adult beneficiaries:

 
  • Pregnancy-related services

  • Emergency services

  • Services provided to residents of an Intermediate Care Facility/Skilled Nursing Facility

  • Services provided to Consumers of the Department of Developmental Services (DDS)

  • Services provided to Genetically Handicapped Person’s Program (GHPP) participants

 

However, the Medi-Cal Dental Program is adding Periodontal Maintenance as a new benefit to:

 
  • All beneficiaries with Full Scope Aid Code

  • Pregnancy-related services

  • Services provided to Consumers of the Department of Developmental Services (DDS)

  • Services provided to Genetically Handicapped Person’s Program (GHPP) participants

 

The criteria for Periodontal Maintenance (D4910) is outlined below. The submission and criteria requirements for the Periodontal Maintenance (D4910) outlined in the MOC will not be updated until the implementation of CDT-16 occurs.

 

PROCEDURE D4910 - PERIODONTAL MAINTENANCE

 
  1. This procedure does not require prior authorization.

  2. A benefit:

    1. Only when preceded by a periodontal scaling and root planing (D4341 - D4342) that has previously been paid by the Medi-Cal Dental Program.

    2. Only after completion of all necessary scaling and root planings.

    3. Once in a calendar quarter.

    4. Only in the 24 month period following the last paid scaling and root planing.

  3. Not a benefit in the same calendar quarter as scaling and root planing.

  4. Not payable to the same provider in the same calendar quarter as prophylaxis-adult (D1110) or prophylaxis-child (D1120).

  5. This procedure is considered a full mouth treatment.