TMPPM 2008 > Texas Medicaid Services > Dental > ICF-MR Dental Services

19.4 ICF-MR Dental Services

ICF-MR dental services are mandated by Medicaid, and reimbursement is provided for treatment of dental problems for Medicaid-eligible residents of ICF-MR facilities who are 21 years of age or older. Residents of ICF-MR facilities who are younger than 21 years of age receive services through the regular THSteps Program. Eligibility for ICF-MR services is determined by DADS.

Procedure codes without a CCP designation in the Limitations column of the dental fee schedule may be billed in a routine manner for ICF-MR clients.

These procedures must be documented as medically necessary and appropriate. ICF-MR clients are not subject to periodicity for preventive care.

For procedure codes with a CCP designation, a provider may request authorization with documentation or provide documentation on the submitted claim.

Refer to: "Medicaid Dental Fee Schedule" .