Dental Manual Archive

Below are the previous versions of the Dental Manual.

Version	Manual Document	Change Notes
2023 - 2 2023 - 1 Archived January 31, 2024	Fee Schedule (XLS 107KB) Policy and Procedure Code Manual (PDF 2.36MB)
2023 - 1 Archived September 29, 2023	Fee Schedule (XLS 128KB)
2022 - 2 2022 - 2 Archived March 9, 2023	Fee Schedule (XLS 108KB) Policy and Procedure Code Manual (PDF 2.3MB)
2022 - 1 Archived December 22, 2022	Fee Schedule (XLS 107KB)
2022 - 1 Archived October 26, 2022	Policy and Procedure Code Manual (PDF 1453KB)
2017-1 Archived April 15, 2022	Handicapping Labio–Lingual Deviation (HLD) Index Report (PDF 898KB)
2021 - 1 2021 - 1 Archived February 17, 2022	Fee Schedule (XLS 108KB) Policy and Procedure Code Manual (PDF 1451KB)
2020 - 1 2020 - 1 Archived March 29, 2021	Fee Schedule (XLS 106KB) Policy and Procedure Code Manual (PDF 82KB)
2019 Archived February 28, 2020	Fee Schedule (XLS 103KB) Policy and Procedure Code Manual (PDF 1.33MB)
2018 - 2 2018 - 2 Archived February 12, 2019	Fee Schedule (XLS 101KB) Policy and Procedure Code Manual (PDF 2.08MB)
2018 - 1 2018 - 1 Archived November 15, 2018	Fee Schedule (XLS 92KB) Policy and Procedure Code Manual (PDF 474KB)
2017 - 1 2017 - 1 Archived March 19, 2018	Fee Schedule (XLS 84KB) Policy and Procedure Code Manual (PDF 867KB)
2012 Archived January 3, 2017	Handicapping Labio–Lingual Deviation (HLD) Index Report (PDF 80KB)
2016 - 2 Archived January 3, 2017	Fee Schedule (XLS 138KB)
2016 Archived January 3, 2017	Policy and Procedure Code Manual (PDF 862KB)
2016 - 1 Archived December 16, 2016	Fee Schedule (XLS 453KB)
2013 Archived December 2, 2016	New York State Medicaid Orthodontic Program FAQs (PDF 150KB)
2012 Archived December 2, 2016	Transition of Dental and Orthodontia Coverage from Fee for Service to Medicaid Managed Care (PDF 1.4MB)
2013 - 1 Archived November 14, 2016	Fee Schedule (XLS 177KB)
2013 - 1 (1/1/13) Archived November 14, 2016	Policy and Procedure Code Manual (PDF 394KB)
2011 - 1 (6/01/11) Archived July 1, 2011	Billing Guidelines (PDF 1.34MB)
2012 - 1 (10/1/12) Archived December 31, 2012	Procedure Codes (PDF 613KB)
2012 - 1 Archived December 31, 2012	Fee Schedule (XLS 284KB)
2011 - 2 (5/15/11) Archived October 1, 2012	Fee Schedule (XLS 96KB)
2011 - 1 (5/15/11) Archived October 1, 2012	Procedure Codes (PDF 397KB)
2009 - 1 (10/01/09) Archived June 20, 2011	Billing Guidelines (PDF 1.03MB)
2011 - 1 (4/01/11) Archived May 26, 2011	Fee Schedule (XLS 83KB)
2008 - 1 (4/01/10) Archived May 26, 2011	Fee Schedule Column Descriptions (PDF 18KB)
2006 - 1 (4/01/06) Archived May 25, 2011	Policy Guidelines (PDF 75KB)
2010 - 1 (4/01/10) Archived May 25, 2011	Procedure Codes (PDF 371KB)
2010 - 1 (4/01/10) Archived April 4, 2011	Fee Schedule (XLS 79KB)
2009 - 1 (1/01/09) Archived April 1, 2010	Fee Schedule (XLS 75KB)
2009 - 1 (1/01/09) Archived April 1, 2010	Procedure Codes (PDF 127KB)
2008 - 4 (11/11/08) Archived October 29, 2009	Billing Guidelines (PDF 353KB)
2007 - 1 (4/01/07) Archived February 23, 2009	Procedure Codes (PDF 110KB)
2007 - 1 (3/23/07) Archived January 26, 2009	Fee Schedule (XLS 70KB)
2008 - 3 (9/09/08) Archived December 8, 2008	Billing Guidelines (PDF 372KB)
2008 - 2 (7/07/08) Archived September 15, 2008	Billing Guidelines (PDF 364KB)
2006 - 1 (11/21/06) Archived August 4, 2008	Prior Approval Guidelines (PDF 147KB)
2008 - 1 (1/16/08) Archived July 24, 2008	Billing Guidelines (PDF 418KB)
2007 - 1 (5/07) Archived January 23, 2008	Billing Guidelines (PDF 437KB)
2005 - 1 (4/01/05) Archived July 18, 2007	Billing Guidelines (PDF 450KB)
2005 - 1 (4/05) Archived April 13, 2007	Procedure Codes & Fee Schedule (PDF 577KB)
2004 - 1	Prior Approval Guidelines (PDF 154KB)