Sec. 10.11.03.16. Billing Procedures for Orthodontic Services  


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  • A. An orthodontist shall comply with all procedures listed in Regulation .13 of this chapter.

    B. The CMS Program shall:

    (1) Reimburse for correction of the full permanent dentition; and

    (2) Give special consideration to services for children with malocclusions in the mixed dentition associated with cleft palates or other craniofacial deformities

    C. The CMS Program may not reimburse for preliminary visits to the orthodontist.

    D. The provider may not charge the patient, parent, or guardian for orthodontic treatment, including retention visits.