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DMS to publish dental fee schedule update next week, rates retroactive to July 1
Summary
The Department for Medicaid Services plans to post a revised dental fee schedule next week that will be retroactive to July 1; DMS said it will monitor utilization and meet with MCOs in September and again in December to decide whether further rate changes are needed.
The Department for Medicaid Services (DMS) told the Technical Advisory Committee on Aug. 7 that it will publish a revised dental fee schedule next week and that the change will be retroactive to July 1.
Justin Deranger, speaking for DMS, said the agency combined the TAC's initial recommendations with DMS priorities and submitted the package to actuarial contractors for review. "By Friday of next week, that that fee schedule will be changed, and we'll have met with our MCO partners at least, preliminarily through email," Deranger said. He added that DMS will review the results in September, make preliminary adjustments, and do a more complete check on Dec. 1 to determine final 2027 fee‑schedule changes.
Why it matters: Providers have urged higher dental rates to increase access for Medicaid members; DMS expects the initial change to be implemented quickly and monitored for utilization effects. DMS said fee‑for‑service claims will be reprocessed automatically when appropriate; managed‑care processing will depend on individual MCO contracts. "Our managed organization partners are light years ahead of us in this, and that's a benefit to having managed organizations," Deranger said, noting that MCO systems typically update faster than state systems.
What comes next: DMS will meet with each MCO to explain the changes and will monitor encounter and utilization data in September and December. If utilization indicates funds remain available, DMS said it may revisit rates in January. The TAC requested actuarial backup and a clearer presentation of the methodology behind the numbers; DMS said it will seek to share that information with the committee subject to actuarial contract terms.
Representative quote: "So the all the the budget people ... looked at the 2025 report for fee for service and encounter data," Deranger said of the actuarial review that informed the new schedule.
Ending: DMS asked TAC members to submit any outstanding code or pricing requests promptly; staff committed to sending the updated fee schedule and supporting materials to TAC members and to scheduling follow‑up briefings.
