| 2023 - 1
Archived September 29, 2023 |
Fee Schedule (XLS 107KB) |
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2022 - 2
2022 - 2
Archived March 9, 2023 |
Fee Schedule (XLS 108KB)
Policy and Procedure Code Manual (PDF 2.3MB)
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| 2022 - 1
Archived December 22, 2022 |
Fee Schedule (XLS 107KB)
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2022 - 1
Archived October 26, 2022 |
Policy and Procedure Code Manual (PDF 1453KB)
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2017-1
Archived April 15, 2022 |
Handicapping Labio–Lingual Deviation (HLD) Index Report (PDF 898KB) |
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2021 - 1
2021 - 1
Archived February 17, 2022 |
Fee Schedule (XLS 108KB)
Policy and Procedure Code Manual (PDF 1451KB)
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2020 - 1
2020 - 1
Archived March 29, 2021 |
Fee Schedule (XLS 106KB)
Policy and Procedure Code Manual (PDF 82KB)
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2019
Archived February 28, 2020 |
Fee Schedule (XLS 103KB)
Policy and Procedure Code Manual (PDF 1.33MB)
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2018 - 2
2018 - 2
Archived February 12, 2019 |
Fee Schedule (XLS 101KB)
Policy and Procedure Code Manual (PDF 2.08MB)
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2018 - 1
2018 - 1
Archived November 15, 2018 |
Fee Schedule (XLS 92KB)
Policy and Procedure Code Manual (PDF 474KB)
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2017 - 1
2017 - 1
Archived March 19, 2018 |
Fee Schedule (XLS 84KB)
Policy and Procedure Code Manual (PDF 867KB)
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2012
Archived January 3, 2017 |
Handicapping Labio–Lingual Deviation (HLD) Index Report (PDF 80KB) |
|
2016 - 2
Archived January 3, 2017 |
Fee Schedule (XLS 138KB) |
|
2016
Archived January 3, 2017 |
Policy and Procedure Code Manual (PDF 862KB) |
|
2016 - 1
Archived December 16, 2016 |
Fee Schedule (XLS 453KB) |
|
2013
Archived December 2, 2016 |
New York State Medicaid Orthodontic Program FAQs (PDF 150KB) |
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2012
Archived December 2, 2016 |
Transition of Dental and Orthodontia Coverage from Fee for Service to Medicaid Managed Care (PDF 1.4MB) |
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2013 - 1
Archived November 14, 2016 |
Fee Schedule (XLS 177KB) |
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2013 - 1 (1/1/13)
Archived November 14, 2016 |
Policy and Procedure Code Manual (PDF 394KB) |
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2011 - 1 (6/01/11)
Archived July 1, 2011 |
Billing Guidelines (PDF 1.34MB) |
|
2012 - 1 (10/1/12)
Archived December 31, 2012 |
Procedure Codes (PDF 613KB) |
|
2012 - 1
Archived December 31, 2012 |
Fee Schedule (XLS 284KB) |
|
2011 - 2 (5/15/11)
Archived October 1, 2012 |
Fee Schedule (XLS 96KB) |
|
2011 - 1 (5/15/11)
Archived October 1, 2012 |
Procedure Codes (PDF 397KB) |
|
2009 - 1 (10/01/09)
Archived June 20, 2011 |
Billing Guidelines (PDF 1.03MB) |
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2011 - 1 (4/01/11)
Archived May 26, 2011 |
Fee Schedule (XLS 83KB) |
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2008 - 1 (4/01/10)
Archived May 26, 2011 |
Fee Schedule Column Descriptions (PDF 18KB) |
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2006 - 1 (4/01/06)
Archived May 25, 2011 |
Policy Guidelines (PDF 75KB) |
|
2010 - 1 (4/01/10)
Archived May 25, 2011 |
Procedure Codes (PDF 371KB) |
|
2010 - 1 (4/01/10)
Archived April 4, 2011 |
Fee Schedule (XLS 79KB) |
|
2009 - 1 (1/01/09)
Archived April 1, 2010 |
Fee Schedule (XLS 75KB) |
|
2009 - 1 (1/01/09)
Archived April 1, 2010 |
Procedure Codes (PDF 127KB) |
|
2008 - 4 (11/11/08)
Archived October 29, 2009 |
Billing Guidelines (PDF 353KB) |
|
2007 - 1 (4/01/07)
Archived February 23, 2009 |
Procedure Codes (PDF 110KB) |
|
2007 - 1 (3/23/07)
Archived January 26, 2009 |
Fee Schedule (XLS 70KB) |
|
2008 - 3 (9/09/08)
Archived December 8, 2008 |
Billing Guidelines (PDF 372KB) |
|
2008 - 2 (7/07/08)
Archived September 15, 2008 |
Billing Guidelines (PDF 364KB) |
|
2006 - 1 (11/21/06)
Archived August 4, 2008 |
Prior Approval Guidelines (PDF 147KB) |
|
2008 - 1 (1/16/08)
Archived July 24, 2008 |
Billing Guidelines (PDF 418KB) |
|
2007 - 1 (5/07)
Archived January 23, 2008 |
Billing Guidelines (PDF 437KB) |
|
2005 - 1 (4/01/05)
Archived July 18, 2007 |
Billing Guidelines (PDF 450KB) |
|
2005 - 1 (4/05)
Archived April 13, 2007 |
Procedure Codes & Fee Schedule (PDF 577KB) |
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| 2004 - 1 |
Prior Approval Guidelines (PDF 154KB) |
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