MedicaidCoverageMedium impact
Clarification on Reimbursement Limitations for Texas Health Steps Dental Preventive Services
Texas Medicaid·TX · Oral & Maxillofacial Surgery, Dentistry·Billing
Effective date
Sep 1, 2023
We identified it
Mar 7, 2026
Summary
Texas Medicaid (TMHP) clarifies that orthodontists and oral maxillofacial surgeons cannot bill for Texas Health Steps preventive dental procedure codes D1110, D1120, D1206, D1208, and D1351. This limitation has been in effect since September 1, 2023, and is not a new benefit change.
Action Required
Immediately: Orthodontists and oral maxillofacial surgeons must stop billing Texas Medicaid for procedure codes D1110, D1120, D1206, D1208, and D1351. Update billing system rules to prevent submission of these codes for Texas Health Steps preventive dental services. Contact the member's specific MCO for details on administrative procedures as they may differ from traditional Medicaid.