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December 2016 Texas Medicaid Provider Procedures Manual

Section 6: Claims Filing : 6.7 2012 American Dental Association (ADA) Dental Claim Filing Instructions

6.7
Providers billing for dental services and Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) dental services may bill electronically or use the 2012 ADA claim form.
Note:

Texas Medicaid & Healthcare Partnership
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