2025 NYS Medicaid Dental Policy and Procedure Code Manual and Updated Fee Schedule are available on eMedNY

Policies in the 2025 Dental Manual became effective January 1, 2025.

Please follow the links in eMedNY to the 2025 Dental Policy and Procedure Codes Manual and Fee Schedule. A "New for 2025" section on page 6 summarizes changes. New language also appears in a purple font, throughout.

Highlights:

• Prior Authorization checklist (page 18)
• Updated language on Private Pay agreements (page 17)
• Table of benefits for the Intellectual/Developmental Disabilities (IDD) population (pages 74-75)

Reminder: A completed Evaluation of the Dental Implant Patient Form is required for all Implant-related prior authorization requests. A completed Justification of Need for Replacement Prosthesis Form is required when requesting prior authorization for replacement prosthetics which exceed frequency limits.

Please contact dentalpolicy@health.ny.gov with questions.