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December 2016 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 8 Children’s Medicaid Dental Services : 8.2 Children’s Medicaid Dental Services Model

Clients primary and preventive Medicaid dental services are provided statewide through Medicaid managed care dental plans. Each Medicaid managed care dental plan is responsible for contracting with general dentists, pediatric dentists, and dental specialists to create a delivery network. Clients who receive their dental services through a Medicaid managed care dental plan are required to select a dental plan and a Main Dentist (or Main Dental Home provider or Dental Home). The client selects the Main Dentist from a provider directory.
A Main Dentist means a provider who has agreed with a Dental Contractor to provide a Dental Home to Members and who is responsible for providing routine preventive, diagnostic, urgent, therapeutic, initial, and primary care to patients, maintaining the continuity of patient care, and initiating referral for care. Provider types that can serve as Main Dental Home Providers are general dentist and pediatric dentist.
The First Dental Home Initiative is included in this model.
Refer to:
Section 4.2.7, “First Dental Home” in the Children’s Services Handbook (Vol. 2, Provider Handbooks).
Services provided through children’s Medicaid dental plans are separate from the medical services provided by the STAR, STAR+PLUS, and STAR Health managed care organizations.

Texas Medicaid & Healthcare Partnership
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