Medicaid Minnesota policy
Dental Authorization Requirement Tables — Orthodontics
Dental Authorization Requirement Tables — Orthodontics is a public Medicaid Minnesota policy (effective Mar 12, 2026). It lists 15 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
- Payer
- Medicaid Minnesota
- Effective
- Mar 12, 2026
- Line of business
- Medicaid
- States
- MN
- Source
- www.dhs.state.mn.us
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other Medicaid Minnesota policies |
|---|---|
| D8010 | Policies naming D8010 |
| D8020 | Policies naming D8020 |
| D8030 | Policies naming D8030 |
| D8040 | Policies naming D8040 |
| D8070 | Policies naming D8070 |
| D8080 | Policies naming D8080 |
| D8090 | Policies naming D8090 |
| D8091 | Policies naming D8091 |
| D8210 | Policies naming D8210 |
| D8220 | Policies naming D8220 |
| D8670 | Policies naming D8670 |
| D8671 | Policies naming D8671 |
| D8680 | Policies naming D8680 |
| D8681 | Policies naming D8681 |
| D8999 | Policies naming D8999 |