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Provider Notice Issued 11/22/2021

Date:    November 22, 2021

To:       Enrolled Dentists

Re:      Dental Service Rate Update Effective for Dates of Service on and after January 1, 2022

________________________________________________________________________________________________________ 

 This notice informs dental providers that the Department is updating dental services' rates effective with dates of service beginning January 1, 2022, to comply with Public Act 102-0016 and
Public Act 102-0043. The rates apply to services provided under both traditional fee-for-service, Medicaid HealthChoice Illinois managed care plans, and the Medicare-Medicaid Alignment Initiative (MMAI).

The table below identifies the affected dental codes with rate increases:

CDT CodeNew RateCDT CodeNew RateCDT CodeNew Rate
D0140$19.12D2160$75.47D5110$444.09
D0150$24.84D2161$75.47D5120$444.09
D0210$35.52D2330$44.98D7140$46.16
D0220$6.61D2331$67.47D7210$67.73
D0230$4.48D2332$80.34D9222$214.00
D0272$11.09D2335$80.34D9223$214.00
D0274$19.94D2391$36.40D9230$46.55
D0330$26.67D2392$56.82D9239$181.00
D1110$48.38D2393$75.47D9243$181.00
D2140$36.40D2394$75.47D9248$150.00
D2150$56.82D2930$95.42  

 

The Dental Fee Schedule has been updated. Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service issues, or to the applicable HealthChoice Illinois managed care plan.

 
Kelly Cunningham, Administrator
Division of Medical Programs




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Illinois Department of Healthcare and Family Services

JB Pritzker, Governor • Theresa Eagleson, Director