Medicaid Minnesota policy

Dental Benefits — Covered Services

Dental Benefits — Covered Services is a public Medicaid Minnesota policy (effective Oct 7, 2026). It lists 121 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

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Payer
Medicaid Minnesota
Effective
Oct 7, 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.

CodeOther Medicaid Minnesota policies
D0120Policies naming D0120
D0140Policies naming D0140
D0145Policies naming D0145
D0150Policies naming D0150
D0160Policies naming D0160
D0170Policies naming D0170
D0180Policies naming D0180
D0210Policies naming D0210
D0220Policies naming D0220
D0230Policies naming D0230
D0240Policies naming D0240
D0250Policies naming D0250
D0270Policies naming D0270
D0274Policies naming D0274
D0277Policies naming D0277
D0330Policies naming D0330
D0340Policies naming D0340
D0350Policies naming D0350
D0364Policies naming D0364
D0368Policies naming D0368
D0372Policies naming D0372
D0373Policies naming D0373
D0374Policies naming D0374
D0389Policies naming D0389
D0999Policies naming D0999
D1110Policies naming D1110
D1120Policies naming D1120
D1206Policies naming D1206
D1208Policies naming D1208
D1301Policies naming D1301
D1310Policies naming D1310
D1320Policies naming D1320
D1321Policies naming D1321
D1330Policies naming D1330
D1351Policies naming D1351
D1354Policies naming D1354
D2140Policies naming D2140
D2161Policies naming D2161
D2330Policies naming D2330
D2394Policies naming D2394
D2710Policies naming D2710
D2722Policies naming D2722
D2930Policies naming D2930
D2934Policies naming D2934
D2940Policies naming D2940
D2976Policies naming D2976
D2989Policies naming D2989
D2991Policies naming D2991
D3110Policies naming D3110
D3120Policies naming D3120
D4322Policies naming D4322
D4323Policies naming D4323
D4341Policies naming D4341
D4342Policies naming D4342
D4346Policies naming D4346
D4355Policies naming D4355
D4910Policies naming D4910
D5110Policies naming D5110
D5140Policies naming D5140
D5211Policies naming D5211
D5226Policies naming D5226
D5410Policies naming D5410
D5422Policies naming D5422
D5511Policies naming D5511
D5520Policies naming D5520
D5611Policies naming D5611
D5640Policies naming D5640
D5650Policies naming D5650
D5671Policies naming D5671
D5710Policies naming D5710
D5721Policies naming D5721
D5730Policies naming D5730
D5761Policies naming D5761
D5810Policies naming D5810
D5811Policies naming D5811
D5820Policies naming D5820
D5821Policies naming D5821
D5850Policies naming D5850
D5851Policies naming D5851
D5863Policies naming D5863
D5866Policies naming D5866
D5992Policies naming D5992
D6010Policies naming D6010
D6049Policies naming D6049
D6050Policies naming D6050
D6058Policies naming D6058
D6068Policies naming D6068
D6080Policies naming D6080
D6081Policies naming D6081
D6090Policies naming D6090
D6092Policies naming D6092
D6093Policies naming D6093
D6094Policies naming D6094
D6110Policies naming D6110
D6113Policies naming D6113
D6180Policies naming D6180
D6194Policies naming D6194
D6199Policies naming D6199
D6280Policies naming D6280
D7000Policies naming D7000
D7220Policies naming D7220
D7252Policies naming D7252
D8010Policies naming D8010
D8040Policies naming D8040
D8070Policies naming D8070
D8090Policies naming D8090
D8091Policies naming D8091
D8671Policies naming D8671
D9110Policies naming D9110
D9222Policies naming D9222
D9247Policies naming D9247
D9248Policies naming D9248
D9311Policies naming D9311
D9410Policies naming D9410
D9610Policies naming D9610
D9612Policies naming D9612
D9630Policies naming D9630
D9910Policies naming D9910
D9920Policies naming D9920
D9951Policies naming D9951
D9952Policies naming D9952

All Medicaid Minnesota policies

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.