As of Jan. 31, 2024, EmblemHealth began covering crowns and root canals in certain circumstances for Medicaid and Health and Recovery Plan (HARP) members. In addition, replacement dentures and implants will only need a dentist’s recommendation to determine if they are necessary.
The New York State Medicaid Program Dental Policy and Procedure Code Manual (Dental Manual) will be updated to reflect:
- Changes to the clinical criteria for coverage of root canals, crowns, replacement dentures, and dental implants to allow for expanded coverage of previously limited dental services.
- Revisions to the coverage policies for these dental services to expand coverage when medically necessary.
- Revisions to the prosthodontics policy that removes limitations on replacement prosthodontics coverage.
JP 64661 02/2024