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Expansion of Medicaid Dental Benefits for Adults with Intellectual and Developmental Disabilities (ID/DD) who are on the Medicaid Home and Community Based Services Waiver for Individuals with Intellectual or Developmental Disabilities (ID Waiver).

The Nevada Division of Health Care Financing and Policy is pleased to announce that temporary expanded dental benefits will be available for adults with ID/DD aged 21 and older who are currently enrolled in Medicaid benefits through the ID Waiver Program through the Nevada Aging and Disability Services Division (ADSD). This dental service is funded through the American Rescue Plan Act (ARPA) effective February 1, 2023.

Before this temporary expansion of Medicaid dental benefits of dental benefits, dental coverage for individuals aged 21 and older on the ID Waiver were limited to emergency extractions and pain management, and some adults were also eligible to receive dentures and partials under certain conditions.

Under the ARPA funded expansion of Medicaid benefits, additional services will be covered for ID Waiver participants, including but not limited to: routine cleaning and deep cleanings for those that qualify, fluoride treatment to help prevent cavities, fillings, crowns, root canals, full dentures, partial dentures, and bite guards.

FAQ Info Packet ID Waiver Expanded Dental Benefits (PDF) opens a new window

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For Individuals on the ID waiver

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You will first need to contact your Regional Center Service Coordinator to discuss your need for dental services.  Your Service Coordinator will verify that you are eligible and update your Person Centered Plan (PCP) to include dental services.  Then, your dentist or any dentist who will provide you with care under this waiver expansion needs to be a current Medicaid provider. The dentist will be able to bill for services without pre-approval after examination and determination that you need dental care, and will need to write a treatment plan for you so that they can be paid for services by the waiver. Providers can verify client eligibity for Medicaid and ID Waiver funder services by accessing the Electronic Verification System (EVS).

Fact Sheet for for Individuals with ID/DD and Caregivers (PDF) opens a new window

Fact Sheet for for Individuals with ID/DD and Caregivers (Spanish)(PDF) opens a new window

For Providers

In order to be eligible for reimbursement, a provider must be enrolled as a Provider Type 22 opens a new window (dentist), fee for service, Medicaid provider. For a patient to be eligible they must be on the ID waiver through Aging and Disability Services Division (ADSD). The maximum reimbursement is $2500 per patient annually Oct – Sept.

See fee schedule and eligible services on the NV Medicaid homepage opens a new window .

ID Waiver Fact Sheet for Providers (PDF) opens a new window
Billing for Individuals on ID Waiver (PDF) opens a new window
Service Codes for IDD Waiver (XLSX) opens a new window

If you are an oral heath care provider, please take a few minutes to respond to this survey. Your input is crucial to helping us identify barriers, challenges and the training needs of providers in order to improve oral health outcomes for people with Intellectual or Developmental Disabilities (ID/DD) across Nevada. (Survey takes approximately 7 minutes to complete.)

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