26 Tex. Admin. Code § 256.71 - Orthodontic Services and Prior Authorization
(a) Orthodontic services for cosmetic reasons
only are not a covered Medicaid service. Orthodontic services must be prior
authorized and are limited to treatment of severe handicapping malocclusion and
other related conditions as described and measured by the procedures and
standards published in the TMPPM.
(b) Prior authorization for orthodontic
services is not transferable to another provider.
(c) Orthodontic services that are authorized
and initiated before a client loses Medicaid eligibility or turns 21 years of
age, can continue beyond the date the client loses eligibility if the services
are completed within 36 months of initiation, as described in the
TMPPM.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.