Association‌ of‌ State‌ &‌ Territorial‌ Dental‌ Directors
3858‌ Cashill Blvd.,‌ Reno,‌ NV‌ ‌89509
Phone‌ 775-626-5008‌‌

Dental Public Health Activities: Descriptive Summaries

The New Mexico Special Needs Dental Procedure Code- Archived Summary

Practice Number: 34005
Submitted By: New Mexico Department of Health and
New Mexico Human Services Department
Submission Date: March 2007
Last Reviewed: March 2007
Last Updated: March 2007
Best Practice Approach Example The New Mexico Special Needs Dental Procedure Code
 
The Special Needs Codes (SNC) is a reimbursement strategy applied to oral health services for Medicaid providers. The code is intended to improve access to oral heath care for those persons who otherwise would not have access to dental care because of complications of their developmental disability that often prevents delivery of such treatment in routine manner. Because evidence suggests that a majority of dental practitioners receive little training in the care of, and issues pertaining to, persons with disabilities, a training program involving didactic and clinical experiences was developed to increase practitioner skills and knowledge. Upon completion of training, a certified dentist is eligible for an encounter fee of $90 (in addition to other billable services) when providing dental care in their dental practice to a person with developmental disabilities. The program has demonstrated that a majority of persons with developmental disabilities can be treated in a traditional dental setting. Only a small percentage of patients with disabilities need to be placed under general anesthesia to receive treatment. Since New Mexico has maintained Medicaid dental benefits for children and adults, this program creates access to care for individuals with disabilities of all ages. Participating practices have become advocates for the oral health needs of persons with developmental disabilities and a network of providers has developed that shares consultative information, provides referrals when appropriate, and supports the maintaining of adult Medicaid benefits, especially for this underserved population.

Contact Person(s) for Inquiries:

Ray A. Lyons, DDS, FADPD, DABSCD, Dental Director, New Mexico Department of Health, Los Lunas Community Program, PO Box 1269, Los Lunas, NM 87031, Phone: 505-841-5270, Fax: 505-841-5316, Email: ray.lyons@state.nm.us
Britt Catron, RDH, MS, CHES, New Mexico Human Services Department, Medical Assistance Division, PO Box 2348, Santa Fe, NM 87504-2348, Phone: 505-827-1348, Fax: 505-827-3185, Email: britt.catron@state.nm.us
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