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The Vermont Statutes Online

 

Title 33 : Human Services

Chapter 019 : MEDICAL ASSISTANCE

Subchapter 004 : COVERAGE FOR DENTAL SERVICES

(Cite as: 33 V.S.A. § 1992)
  • § 1992. Medicaid coverage for adult dental services

    (a) Vermont Medicaid shall provide coverage for medically necessary dental services provided by a dentist, dental therapist, or dental hygienist working within the scope of the provider's license as follows:

    (1) Up to two visits per calendar year for preventive services, including prophylaxis and fluoride treatment, with no co-payment. These services shall not be counted toward the annual maximum benefit amount set forth in subdivision (2) of this subsection.

    (2) Diagnostic, restorative, and endodontic procedures, to a maximum of $1,000.00 per calendar year, provided that the Department of Vermont Health Access may approve expenditures in excess of that amount when exceptional medical circumstances so require.

    (3) Other dental services as determined by the Department by rule.

    (b) The Department of Vermont Health Access shall develop a reimbursement structure for dental services in the Vermont Medicaid program that encourages dentists, dental therapists, and dental hygienists to provide preventive care. (Added 2019, No. 72, § E.306.1.)