Non-dentist services use Medicaid children: MN Public Health Data Access - MN Dept. of Health
Non-dentist oral health service use among Medicaid eligible children
Non-dentist oral health service use among Medicaid eligible children by:
Integrating preventive dental services and referrals in primary medical care
All children enrolled in a Minnesota Health Care Program can receive oral health services from non-dentist providers, i.e. primary care doctors and oral health professionals. Examples of covered oral health services include an oral health screening composed of an oral health history review, a physical examination of the child’s mouth, and referrals for preventive dental care or assessment and treatment, nutrition and tobacco counseling, oral hygiene instruction, fluoride application and fluoride varnish.
"Better integration of primary medical care with dental care can help identify children at risk for tooth decay at the youngest age possible, offer evidence-based preventive care such as fluoride varnish and oral health education, and refer children to a dental professional for a complete check-up and any needed treatment. Three oral health risk assessment CDT billing codes can support this approach, potentially preventing the need for costly treatment, such as that provided in an operating room."—EPSDT-A Guide for States: Coverage for Medicaid Benefit for Children and Adolescents. U.S. Department of Health and Human Services. Centers for Medicare and Medicaid Services. June 2014. Pages 14-15.
Child and Teen Checkups (C&TC) is Minnesota’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program—a federal program required in every state to provide children enrolled in a Medicaid or public health insurance program with yearly well-child care health and dental visits.
Children eligible for Minnesota’s C&TC services include all children under the age of 21 enrolled in a Medicaid or Children Health Insurance (CHIP) expansion program (Medical Assistance) or MinnesotaCare (collectively called Minnesota Health Care Programs).
The following is based on data from the CMS-416 Report, which reports on oral health measures such as non-dentist oral health service use among children:
- Aged 1 to 20 years.
- Enrolled in a Minnesota Health Care Program (MHCP) for at least 90 continuous days.
- By federal fiscal year (October 1 through September 30).
A non-dentist oral health service is any diagnostic, preventive, or treatment service provided by a non-dentist such as a primary care doctor or oral health professional not under the supervision of a dentist.
Fluoride varnish application is an oral health service that can be provided by both a dentist and a primary care doctor. Fluoride varnish strengthens tooth enamel and can prevent cavities. MHCP pays for application of fluoride varnish once every six months in children (Minnesota Statutes 2018, chapter 256B.0625, subd. 9). For more information: About the Child and Teen Checkups Program (CMS-416) Report.
One in 10 C&TC eligible children receive at least one yearly non-dentist oral health service
Non-dentist oral health service use decreased to 15% in 2020. The COVID-19 pandemic is likely playing a role in access to non-dentist oral health services.
Prior to this, a policy change in October 2018 resulted in fluoride varnish application added to the required C&TC schedule. Non-dentist oral health service use subsequently increased from 6% in 2017, to 13% in 2018 and 17% in 2019.
1 out of every 10
C&TC eligible children (1 to 20 years)
(15.1%, 95% CI = 15.0 to 15.2; n =84,295 of 558,042)
Have at least one non-dentist oral health service
FFY 2020
Non-dentist oral health service use among Child and Teen Checkups (C&TC) eligible children by age, federal fiscal year 2020
| Age group (years) | Number of C&TC eligible children | Number of C&TC eligible children with at least one non-dentist oral health service | Percent C&TC eligible children with at least one non-dentist oral health service within age groups (row percent) | 95% Confidence Interval |
|---|---|---|---|---|
| Less than 1 | 23,469 | 5,423 | 23.1% | 22.6 to 23.6 |
| 1 to 2 | 61,595 | 36,906 | 59.9% | 59.5 to 60.3 |
| 3 to 5 | 93,445 | 34,641 | 37.1% | 36.8 to 37.4 |
| 6 to 9 | 119,016 | 7,211 | 6.1% | 5.9 to 6.2 |
| 10 to 14 | 143,687 | 3,898 | 2.7% | 2.6 to 2.8 |
| 15 to 18 | 98,919 | 1,428 | 1.4% | 1.4 to 1.5 |
| 19 to 20 | 41,380 | 211 | 0.5% | 0.4 to 0.6 |
Data include Child and Teen Checkups (C&TC) eligible children enrolled in a Minnesota Health Care Program for at least 90-continuous days during the federal fiscal year (FFY) (October 1 through September 30). Total eligible children (1 to 20 years) enrolled during FFY 2020= 558,042. This chart represents percent non-dentist oral health service use within age groups (row percentages). SeeAbout the Child and Teen Checkups Program (CMS-416) Report data for more information.
A non-dentist oral health service is any diagnostic, preventive, or treatment service provided by a non-dentist such as a primary care doctor or oral health professional not under the supervision of a dentist. Data is based on all unduplicated counts of paid, unpaid, and denied claims submitted for reimbursement from fee-for-service providers, managed care plans, Indian Health Services, and Federally Qualified Health Centers that contract with the Minnesota Department of Human Services. This chart represents percent non-dentist oral health service use within age groups (row percentages).
During fiscal year 2020, children aged 0 to 5 years were 13.5 times more likely to receive a non-dentist oral health service than children aged 6 to 20 years.
Non-dentist oral health service use among Child and Teen Checkups (C&TC) eligible children by race and ethnicity, federal fiscal year 2020
| Race and ethnicity | Number of C&TC eligible children (1 to 20 years) |
Number of C&TC eligible children (1 to 20 years) with at least one non-dentist oral health service |
Percent C&TC eligible children (1 to 20 years) with at least one non-dentist oral health service within race and ethnicity groups (row percent) |
95% Confidence Interval |
|---|---|---|---|---|
| Asian or Pacific Islander | 26,723 | 3,814 | 14.3% | 13.9 to 14.7 |
| Hispanic/Latino | 61,722 | 8,494 | 13.8% | 13.5 to 14.0 |
| African American or Black | 73,572 | 9,926 | 13.5% | 13.2 to 13.7 |
| Two or more races | 24,675 | 2,889 | 11.7% | 11.3 to 12.1 |
| White | 168,074 | 17,257 | 10.3% | 10.1 to 10.4 |
| American Indian/Alaska Native | 14,772 | 1,089 | 7.4% | 7.0 to 7.8 |
Data include Child and Teen Checkups eligible children enrolled in a Minnesota Health Care Program for at least 90-continuous days during the federal fiscal year (FFY) (October 1 through September 30). Total eligible children (1 to 20 years) enrolled during FFY 2020 with a known single race and ethnicity or two or more races = 369,538. Unknown or missing race and ethnicity (not shown in this chart) = 40,826 with at least one non-dentist oral health service out of 188,504 eligible. Two or more races = any combination of two or more single race and ethnicity. This chart represents percent non-dentist oral health service use within race and ethnicity groups (row percentages). See About the Child and Teen Checkups Program (CMS-416) Report data for more information.
A non-dentist oral health service is any diagnostic, preventive, or treatment service provided by a non-dentist such as a primary care doctor or oral health professional not under the supervision of a dentist. Data is based on all unduplicated counts of paid, unpaid, and denied claims submitted for reimbursement from fee-for-service providers, managed care plans, Indian Health Services, and Federally Qualified Health Centers that contract with the Minnesota Department of Human Services. This chart represents percent non-dentist oral health service use within race and ethnicity groups (row percentages).
Compared to federal fiscal year 2019, non-dental oral health service use decreased among all racial/ethnic groups in federal fiscal year 2020. American Indian/Alaska Native children eligible for C&TC continue to have the lowest rate of non-dental oral health service use.
C&TC eligible children (1 to 20 years) non-dentist oral health service use, federal fiscal year 2020
Child and Teen Checkups eligible children include all children enrolled in a Minnesota Health Care Program (Medical Assistance or Medicaid, MNCare) for at least 90-continuous days during the federal fiscal year (FFY) Oct. 1 through Sept. 30). Total eligible children (1 to 20 years) enrolled during FFY 2020 = 558,042. See About the Child and Teen Checkups Program (CMS-416) Report data for more information.
A non-dentist oral health service is any diagnostic, preventive, or treatment service provided by a non-dentist such as a primary care doctor or oral health professional not under the supervision of a dentist. Data is based on all unduplicated counts of paid, unpaid, and denied claims submitted for reimbursement from fee-for-service providers, managed care plans, Indian Health Services, and Federally Qualified Health Centers that contract with the Minnesota Department of Human Services. See About the Child and Teen Checkups Program (CMS-416) Report data for more information.
During federal fiscal year 2020, C&TC eligible children in Nobles County (23%) had the highest non-dental oral health service use and C&TC eligible children in Lake of the Woods County (2%) had the lowest non-dentist oral health service use. Some counties were statistically different from the statewide rate.