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The All Kids School-Based Dental Program allows registered dental providers to provide out-of-office delivery of preventive dental services in a school setting to children ages 0–18. Chapter 12 of the Dental Office Reference Manual contains more detailed information. 

To become an approved All Kids School-Based Dental Provider the items listed below must be completed.

  1. 1.  Registration Form
  2. 2.  Team Up Calendar 
  3. 3.  Attend Conference Call
  4. 4.  Provider must be able to provide all School dental Services
  •      ​D0120 – Periodic Oral Examination
  •      D1120 – Prophylaxis – Child
  •      D1206 – Topical Application of Fluoride Varnish
  •      D1208 – Topical Application of Fluoride (excluding prophylaxis)
  •      D1351 – Sealant – Per Tooth
  •      D0601 - child has no visual signs of decay - advise to see dentist twice a year.
  •      D0602 - child has cavity/cavities – advise child needs follow check-up with dentist.
  • ​     D0602 - child has dental disease – child needs to go to dentist now for dental toothache.

When the dental provider is providing dental services in the school setting, all the check list items listed below need to be followed for each child seen in the school.

  1. ​1.       Receive a signed Consent Form
  2. 2.       Complete and maintain a Dental Record
  3. 3.       Complete an IDPH Proof of School Dental Examination Form, found under Oral Health
  4. 4.       Provide a completed School Follow up Form for the school to provide to the parent/guardian.
  5. 5.       A Referral Plan for all children that receive D0602 and D0603 CRA Codes must be included in School Follow Up Form.
  6. 6.      To find  dental providers that are enrolled in MCO plans to be able to complete the Referral Plan refer to the InsureKidsNow web site.
  7. 7.      When submitting school services for reimburse claim must contain one of the Caries Risk Assessment Codes (D0601 – D0603) to receive reimbursement.

Site visits will be conducted by the Illinois Department of Public Health on behalf of the Department of Healthcare and Family Services. School based providers must have fully functioning dental equipment that includes suction, air/water syringe, compressor, vacuum, and direct light source. Providers with malfunctioning or in-operable dental equipment will be required to cease all school-based services until all dental equipment operations meet required standards.


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Illinois Healthcare and Family Services

JB Pritzker, Governor • Theresa Eagleson, Director