Source: Minnesota Department of Human Services. Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)/Child and Teen Checkups (C&TC) (CMS-416) Report.
State Medicaid agencies are required to report annually on Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services, submitted on the CMS-416 Report form. Child and Teen Checkups (C&TC) is Minnesota’s EPSDT program. The annual report provides basic information on the number of children (by age and basis of Medicaid eligibility) who receive medical or dental screenings and the number referred for diagnostic or treatment services.
This dataset includes only information relevant to dental services (Line 1b. and Lines 12a through 12g on the CMS-416 Report form. CT&C eligibility is determined by the state of Minnesota, and includes children under age 21 enrolled for 90 consecutive days in Medicaid, Children Health Insurance (CHIP) Program, or MinnesotaCare (collectively known as Minnesota Health Care Programs). Reporting agencies include select fee-for-service and managed care plans, and select Indian Health Services and Federally Qualified Health Centers that contract with the Minnesota Department of Human Services.
- “Unduplicated” means that an individual may be counted only once on each line item (Line 1b. and Lines 12a through 12g) on the CMS-416 Report. However, an individual may be counted on two or more line items. For example, an individual may be counted once on Line 12A for receiving any dental service, counted again on Line 12c for receiving a dental treatment service, and if applicable counted again on Line 12f for receiving an oral health service by a non-dentist provider.
- “Dental services” refers to services provided by or under the supervision of a dentist. Supervision is a spectrum and includes, for example, direct, indirect, general, collaborative or public health supervision as provided in the state’s dental practice act.
- “Oral health services” refers to services provided by any qualified health practitioner or by a dental professional who is neither a dentist nor providing services under the supervision of a dentist.
- The CMS-416 Report provides instructions that link appropriate procedure codes (HCPCS, or equivalent CPT or CDT codes) for each dental line (Lines 12a through 12g) in the report.
At a minimum C&TC dental services include relief of pain and infections, restoration of teeth and maintenance of dental health. Dental services may not be limited to emergency services. Each state is required to develop a dental periodicity schedule in consultation with recognized dental organizations involved in child health.
Data summarized by ‘Ages (1-20 years) combined’ is based on the Centers for Medicaid and Medicare (CMS) Core Dental Measures 13 and 17, Improving Access to Oral Health Services in Medicaid and CHIP: How States Can Report the Dental Measures in the Initial Core Set of Children’s Health Care Quality Measures.
In federal fiscal years 2011 and 2012, the ‘other/unknown’ racial category included C&TC eligible children with a single race of Hawaiian or Pacific Islander, more than one race, or did not report a race and ethnicity. Since federal fiscal year 2013, ‘Pacific Islanders’ were included in the ‘Asian’ racial category; individuals reporting more than one race were combined into a ‘mixed race’ category; and race and ethnicity that was not reported or unknown were combined into an ‘unknown/missing’ category.
**Indicates data suppression due to small numbers (5 or less).
For more information: About the Data: Child and Teen Checkups Program (CMS-416) Report.