Q4 Word of Mouth newsletter 2024
The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit under Medicaid is crucial for the health of children and adolescents. This benefit helps ensure that young patients receive comprehensive preventive, diagnostic and treatment services, including dental care, through programs like RIte Smiles.
Key dental services under EPSDT
- Comprehensive care: Treatment for pain, infection, restoration of teeth and upkeep of dental health starting at as early of an age as necessary
- Preventive services: Prophylaxis, topical fluoride and assessment for pit and fissure sealants
- Emergency services: Addresses dental diseases like tooth decay to prevent serious complications
The following is a list of service codes included in EPSDT:
- Dental services: D0100 – D9999
- Preventive dental services: D1000 - D1999
- Dental treatment services: D2000 – D9999
- Sealant on a permanent molar tooth: D1351
- Diagnostic dental services: D0100 – D0999
For more information on EPSDT visit Dental Care | Medicaid.
EPSDT requirements
Health care professionals agree to provide early and periodic dental screening, diagnosis and treatment services to eligible children enrolled in the RIte Smiles plan in accordance with the Rhode Island EPSDT Periodicity Schedule.
- Screening: Conduct regular EPSDT screenings to identify dental issues early
- Diagnosis and treatment: Provide necessary follow-up diagnostic and treatment services, even if they exceed the periodicity schedule
- Tracking: Maintain a system to track compliance with EPSDT service requirements
- Follow-up and outreach: Implement reminder and follow-up protocols, considering the unique needs of the Medicaid population
- Transportation services: Inform members they are eligible for transportation services for dental appointments through MTM, Inc.
- Members should be referred to call MTM at 855-330-9131 (TTY 711) to request transportation assistance
- Interpreter services: Offer professional interpreter services for dental appointments, ensuring accessibility for all members
- Members can request an interpreter by calling Member Services at 866-375-3257 (TTY 711) at least 72 hours before the scheduled appointment.
Review the RIte Smiles Dental provider manual for a full overview of EPSDT requirements.