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Medicaid expenditures for orthodontic services.

El-Gheriani AA, Ehrmantrout ZP, Oesterle LJ, Berg R, Wilkerson DC

Department of Orthodontics, School of Dentistry, University of Colorado at Denver and Health Sciences Center, Aurora, Colo 80045, USA.

INTRODUCTION: A survey was conducted in 2006 to determine, on a state-by-state basis, the availability of Medicaid-funded orthodontic treatment and, when available, the criteria and the funding rates. METHODS: All 50 states were contacted by e-mail, telephone, or standard mail to obtain answers to the following questions. Does your state provide Medicaid coverage for orthodontic services? What qualifications are required to be reimbursed? What is the patient cutoff age for reimbursement of services? Is an index used to assess malocclusion? If so, which index? What is the primary training of the reviewer? How are services reimbursed? Is limited treatment covered? Is interceptive treatment covered? What is the total amount reimbursed for 24 months of treatment for comprehensive adolescent care? RESULTS: Wide variations of responses were received from the states, with no statistical significance between any questions based on geographic regions or reimbursement rates, although some trends appeared to exist. CONCLUSIONS: This study provides state-by-state details of Medicaid programs for orthodontic services and details the extensive variations in programs.

Published 10 December 2007 in Am J Orthod Dentofacial Orthop, 132(6): 728.e1-8.
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