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Update to TMPPM and CSHCN Services Program Provider Manual for Dental Procedure Code D2910

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, precertification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

Beginning April 1, 2023, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM) and the Children with Special Health Care Needs (CSHCN) Services Program Provider Manual to add the limitation for dental procedure code D2910.

Procedure code D2910 will be denied if billed with the following procedure codes within one rolling year for the same tooth identification, same provider:

Procedure Codes

D2510

D2520

D2530

D2542

D2543

D2544

D2650

D2651

D2652

D2662

D2663

D2664

The limitation will be added to:

  • The Texas Medicaid Provider Procedures Manual, Children’s Services Handbook, 3.2.15 “Restorative Services.”
  • The Children with Special Needs (CSHCN) Services Program Provider Manual, subsection 14.2.6.4 “Restorations.”

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.