Medicaid and CHIP dental benefits play a vital role in expanding access to oral health care for children and adolescents. Yet, many providers, including those in private practice and community health centers, face confusion about what services are covered, how reimbursement rates are set, and how to ensure their billing practices reflect the true value of care delivered.
Join CareQuest Institute for a webinar that will explain the federal EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefit and its implications for dental providers. Our expert speaker will clarify foundational concepts such as medical necessity in dentistry, the medical loss ratio, and Medicaid dental managed care. The discussion will also address common billing misconceptions, including the importance of submitting usual and customary fees rather than limiting claims to expected reimbursement, and offer guidance for providers who currently accept, or are considering accepting, Medicaid.
Learning Objectives
- Explain the core components of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) dental benefit, including how “medical necessity” is defined and applied in Medicaid policy.
- Describe how Medicaid dental reimbursement rates are established, including the role of medical loss ratio and the impact of billing practices on rate-setting.
- Identify practical billing strategies, including the use of usual and customary fees that support accurate reporting, equitable reimbursement, and the long-term sustainability of Medicaid dental programs.
Moderator
Sherry Jenkins, BS, RDH, MCNA Dental
Presenter
Linda M. Altenhoff, DDS, MCNA Dental
This webinar will be recorded.
CareQuest Institute for Oral Health is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. CareQuest Institute for Oral Health designates this activity for 1 continuing education credit.
This continuing education activity has been planned and implemented in accordance with the standards of the ADA Continuing Education Recognition Program (ADA CERP) by CareQuest Institute for Oral Health.
All participating instructors in this program have disclosed that they do not have any financial arrangement or affiliation with persons or entity(ies) offering financial support, products, and/or services mentioned or related to the content of this program/activity.