Medicaid and Medicare Resources

Incorporating Medicaid into an Ohio Dental Practice

• New Medicaid Dental Fees are Now Final
• Medicaid Fee Schedule
• Medicaid Covered Dental Services
• Become a Medicaid Provider
• Medicaid Provider Enrollment FAQ
• Understanding the Gaps Between Adult Medicaid Beneficiaries and Dentists

Webinar: Ohio Medicaid Update

The Ohio Dental Association has created a video that provides practical steps on how to successfully incorporate Medicaid into an Ohio Dental Practice. Click here to watch the entire video, or skip to a specific section by browsing the chapters below.

• Medicaid and Medicaid Participation Considerations
• Basics of Medicaid and Background Information
• Industry Challenges
• Medicaid Participation Considerations
• Moving Forward

Resources for Dentists who Treat Patients Covered by Medicaid

• Information and Resources to Assist Dentists with Medicaid
• Overview of Ohio’s Medicaid HMOs
• Ohio Medicaid HMO report cards
• Comparison of Ohio Medicaid HMOs
• Medicaid and CHIP information from the ADA
• ADA support for Medicaid participation and utilization

New Resource: Medicaid Orthodontic Prior Authorization Form

• Medicaid Orthodontic Prior Authorization Form (ODM Form 03630)

This form takes effect on January 1, 2026 and identifies, scores and records conditions to evaluate the potential of meeting medical necessity criteria of D8080 (comprehensive orthodontic treatment of the adolescent dentition) cases for Medicaid benefit eligibility.  It is scientifically based and provides a new level of transparency, reliability and accountability for all involved in the prior authorization process.  It was developed jointly by the ODA, all of Ohio’s Medicaid HMOs and the Ohio Department of Medicaid and is a standardized form that will be used by ODM and all of Ohio’s Medicaid HMOs and/or their dental administrators.

ODA Medicaid Advocacy

Thanks to advocacy over the past several years, reimbursements for dental services in Ohio’s Medicaid program have increased by an average of 93% across all covered services.

• New Report Shows Dramatic Improvement in Ohio’s Dental Medicaid Program
• ODA Petitions Ohio Medicaid to Standardize Administration of the Dental Medicaid Program
• Ohio Medicaid Responds to ODA Request to Standardize Administration of the Medicaid Dental Program and Encourages Dentists to File Formal Complaints for Unresolved Medicaid/HMO Dental Administrator Disputes

ODA Medicaid Working Group

The ODA Medicaid Working Group works to address issues related to the Medicaid program on behalf of both individual dentists who are having problems resolving issues and the profession as a whole. Within the last few years, the ODA and Ohio Department of Medicaid (ODM) worked successfully together in addressing a number of issues that served as roadblocks to dentists’ participation in the Ohio Medicaid program.

The ODA Medicaid Working Group is appointed by the ODA Council on Access to Care and Public Service. Members serve a one-year term. Current appointees cover a wide range of different dental specialties and practice types.

Resources for Dentists who Treat Patients Covered by Medicare

• Overview of Medicare and Dentistry and Medicare Advantage Frequently Asked Questions
• The New Medicare Dental Benefit—Small but Mighty