Medicaid Minnesota policy

Dental Services — Noncovered Services

Dental Services — Noncovered Services is a public Medicaid Minnesota policy (effective Feb 24, 2025). It lists 4 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy ↗

Payer: Medicaid Minnesota
Effective: Feb 24, 2025
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
D0150	Policies naming D0150
D0180	Policies naming D0180
D3110	Policies naming D3110
D3120	Policies naming D3120

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.