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Published on: October 20, 2023
Medicaid expenditures for orthodontic services.
Abdelhakim A El-Gheriani1, Zachary P Ehrmantrout, Larry J Oesterle
1Department of Orthodontics, School of Dentistry, University of Colorado at Denver and Health Sciences Center, Aurora, Colo 80045, USA.
Summary
Medicaid orthodontic coverage varies significantly by state. A 2006 survey revealed wide differences in criteria, reimbursement, and treatment coverage for orthodontic services funded by Medicaid.
Area of Science:
- Dental Public Health
- Health Services Research
Background:
- In 2006, a survey assessed Medicaid-funded orthodontic treatment availability across all US states.
- The study examined program criteria, reimbursement policies, and funding rates.
Purpose of the Study:
- To determine the state-by-state availability of Medicaid orthodontic services.
- To identify variations in eligibility criteria, reimbursement methods, and funding levels.
Main Methods:
- A comprehensive survey was conducted contacting all 50 states via email, phone, or mail.
- Data collected included coverage status, qualification requirements, age limits, malocclusion assessment indices, reviewer training, reimbursement structures, and coverage for limited/interceptive treatments.
Main Results:
- Significant variations in Medicaid orthodontic program structures were observed across states.
- No statistical significance was found based on geographic regions or reimbursement rates, though trends were noted.
- Responses highlighted extensive differences in how orthodontic services are covered and funded.
Conclusions:
- The study details the diverse landscape of state-specific Medicaid orthodontic programs.
- Findings underscore the considerable heterogeneity in orthodontic care access and provision within the Medicaid system.
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