January/February 2024 | Page 10

Government Relations
Pennsylvania Medicaid Fee Increases
The Pennsylvania General Assembly passed a budget bill in December 2023 that :
• Provides a one-time payment to dentists enrolled in the Medical Assistance ( MA ) program . The amount will be determined by dividing the number of claims from a MA dentist ’ s managed care organization utilization from calendar year 2022 of the codes included in the chart below , by the total claims from all MA dentists ’ managed care organization utilization from calendar year 2022 of the same codes , and multiplying this quotient by $ 12 million in funding from the legislature .
• Appropriates another $ 12 million to be used by the Department of Human Services ( DHS ) to increase the calendar year capitation rates for the same codes included in the chart below , beginning January 1 , 2025 .
• DHS will apply for matching funds from the federal government in the amount of $ 24 million , which will also be used for the purposes outlined above .
D0120
Periodic oral examination-established patient
D0150
Comprehensive oral examination — new or established patient
D0272
Bitewings — two radiographic images
D0274
Bitewings — four radiographic images
D1110
Prophylaxis--adult
D1120
Prophylaxis — child
D1206
Topical application of fluoride varnish
D1351
Sealant — per tooth
D2391
Resin-based composite — one surface , posterior
D2392
Resin-based composite , two surfaces , posterior
D7140
Extraction , erupted tooth or exposed root ( elevation and / or forceps removal )
D0220
Intraoral - periapical first radiographic image
D0230
Intraoral - periapical each additional radiographic image
D1208
Topical application of fluoride ¬ excluding varnish
D2393
Resin-based composite – three surfaces , posterior
D2751
Crown – porcelain fused to predominantly base metal
D4341
Periodontal scaling and root planing – four or more teeth per quadrant
D5110
Complete denture – maxillary
D5120
Complete denture – mandibular
D5213
Maxillary partial denture – cast metal framework with resin denture bases
( including retentive / clasping materials , rests and teeth )
D5214
Mandibular partial denture – cast metal framework with resin denture bases
( including retentive / clasping materials , rests and teeth )
D0330
Panoramic radiographic image
D2140
Amalgam – one surface , primary or permanent
D2150
Amalgam – two surfaces , primary or permanent
D2331
Resin-based composite – two surfaces , anterior
D2930
Prefabricated stainless steel crown ¬ primary tooth
D2933
Prefabricated stainless steel crown with resin window
D3220
Therapeutic pulpotomy ( excluding final restoration ) - removal of pulp coronal to the
dentinocemental junction and application of medicament
D3230
Pulpal therapy ( resorbable filling ) ¬ anterior , primary tooth ( excluding final restoration )
D8080
Comprehensive orthodontic treatment of the adolescent dentition
D9230
Inhalation of nitrous oxide / analgesia , anxiolysis
8 JANUARY / FEBRUARY 2024 | PENNSYLVANIA DENTAL JOURNAL