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Dental Manual Archive

Below are the previous versions of the Dental Manual.

Version Manual Document Change Notes

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)  
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