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Dental Therapist (DT)

Revised: February 19, 2020

Overview

Legislation allows Minnesota Health Care Programs (MHCP) to enroll individual Dental Therapists (DT) to provide oral health services for MHCP members as specified within their scope and collaborative management agreement.

All DTs providing services for MHCP members must enroll and be identified as the treating provider on claims.

DTs providing services to members in a managed care organization (MCO) must contact the MCO directly for enrollment requirements and coverage policy.

Services are primarily provided in settings that may include assisted living facilities, Federally Qualified Health Centers (FQHC), rural health clinics (RHC), community health clinics (CHC) or Indian Health Service (IHS) clinics. DTs may practice in settings separate from the dentist under a Collaborative Management Agreement (CMA) with a licensed Minnesota Dentist who provides general supervision for services listed in Minnesota Statutes, 150A.105, subdivision 4(c) and under indirect supervision for services listed in Minnesota Statutes, 150A.105, subdivision 4(d).

The DT:

· Must follow the Collaborative Management Agreement’s (CMA) specific written protocols before performing any of the services authorized.

· May supervise up to four licensed or non-registered dental assistants at any one setting as defined in the CMA.

Covered Services

A DT certified by the Minnesota Board of Dentistry may perform the services and procedures within their scope of practice as identified in Minnesota Statutes, 150A.105, subdivisions 4(c) and 4(d) and as specified in their written CMA.

Noncovered Services

Services not designated in the CMA.

The DT is prohibited from providing, dispensing, or administering a narcotic drug.

Billing

Bill all services completed using the following:

· 837D format.

· Appropriate group NPI as the pay-to provider (provider receiving payment).

· Individual DT NPI as the rendering provider.

Reimbursement Rates

DT services must be billed by an eligible MHCP-enrolled group provider using the individual DT NPI as the rendering provider to receive payment.

Reimbursement for services provided by DTs will be made at the rate of:

· 100 percent for DT services.

· 100 percent for collaborative practice dental hygiene services by qualified DTs also practicing under limited authorization.

· Face-to-face encounter rates are reimbursed for DTs affiliated with RHC's, FQHC's, and IHS's.

Legal References

Minnesota Statutes, 256B.0625, subdivision 59 (Services provided by advanced dental therapists and dental therapists)
Minnesota Statutes, 150A.10, subdivision 1a (Collaborative practice authorization for dental hygienists in community settings)
Minnesota Statutes, 150A.105 (Dental therapist)
Minnesota Statutes, 150A.105, subdivisions 4(c) and 4(d) (Dental therapist allowed dental services)

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