Utah Administrative Code

The Utah Administrative Code is the body of all effective administrative rules as compiled and organized by the Division of Administrative Rules (see Subsection 63G-3-102(5); see also Sections 63G-3-701 and 702).

NOTE: For a list of rules that have been made effective since April 1, 2019, please see the codification segue page.

NOTE TO RULEFILING AGENCIES: Use the RTF version for submitting rule changes.


R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

Rule R414-49. Dental, Oral and Maxillofacial Surgeons and Orthodontia.

As in effect on April 1, 2019

Table of Contents

R414-49-1. Introduction.

The Medicaid Dental Program provides a scope of dental services for Medicaid recipients in accordance with the Dental, Oral Maxillofacial, and Orthodontia Services Utah Medicaid Provider Manual and Attachment 4.19-B of the Medicaid State Plan, as incorporated into Section R414-1-5.

R414-49-2. Dental Services for the Blind or Disabled.

(1) Introduction and Authority.

(a) This section defines the scope of dental services available to blind or disabled Medicaid members who are 18 years of age or older.

(b) Dental services are authorized by 42 CFR 440.100, 440.120, and 483.460. This rule is also authorized under Sections 26-1-5 and 26-18-3.

(2) Definitions.

(a) "Dental services" whether furnished in the office, a hospital, a skilled nursing facility, or elsewhere, means covered services performed within the scope of the Medicaid dental provider's license as defined in Title 58, Occupations and Professions.

(b) "Blind or disabled" is as defined in Subsection 1614(a) of the Social Security Act.

(3) Client Eligibility Requirements.

(a) Dental Services are available to blind or disabled members who are 18 years of age or older.

(4) Program Access Requirements.

(a) Dental services are available only from a dental provider who has a current Utah Medicaid provider agreement, and has complied with all relevant laws and policy.

(5) Covered Services.

(a) Covered Services and limitations are maintained in the Utah Medicaid Coverage and Reimbursement Code Lookup and the Dental, Oral Maxillofacial, and Orthodontia Services Utah Medicaid Provider Manual.

KEY

Medicaid

Date of Enactment or Last Substantive Amendment

July 1, 2017

Notice of Continuation

June 17, 2014

Authorizing, Implemented, or Interpreted Law

26-1-5; 26-18-3


Additional Information

Contact

For questions regarding the content or application of rules under Title R414, please contact the promulgating agency (Health, Health Care Financing, Coverage and Reimbursement Policy). A list of agencies with links to their homepages is available at http://www.utah.gov/government/agencylist.html or from http://www.rules.utah.gov/contact/agencycontacts.htm.