Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth	
	MassHealth
Chronic Disease and Rehabilitation Inpatient Hospital Bulletin 87
	May 2007

	TO:	Chronic Disease and Rehabilitation Inpatient Hospitals Participating in MassHealth

	FROM:	Tom Dehner, Acting Medicaid Director 

	RE:	Dental Services Exempted From the Physical Presence Requirement

Background	The purpose of this bulletin is to clarify the physical oversight requirements for dentists in dental residency programs. Certain services no longer require physical oversight from supervisory dentists.

Clarification	Hospitals may submit claims for the services outlined below when
performed by dental residents employed by the facility. These services are no longer subject to the requirements of 130 CMR 450.275.

Dental regulations will be revised at a later date to reflect these changes.

Exempted Services	The following services no longer require physical oversight from supervisory dentists.

	Diagnostic procedures:
•	oral exams
•	taking and evaluating radiographs
•	periodontal probing
•	ordering necessary tests
•	ordering and interpreting consultations

                                               Preventive procedures:                                                 
•	prophylaxis
•	scaling
•	topical fluoride application
•	dental sealants
•	prescribing systemic and topical fluorides
	
                                                                             (continued on next page)

	

Exempted Services	Restorative dentistry on primary and permanent teeth:
(cont.)		 posterior composites/glass ionomers
•	amalgam restorations
•	stainless-steel crowns
		 anterior crowns
		 full cast crowns
•	basic prosthetic service (both removable and fixed)
•	pulp therapy
•	simple endodontics
•	fabrication and insertion of space maintainers

Basic pediatric dental surgical procedures on primary and permanent 
                                               	teeth: 
•	extraction of carious teeth
•	extraction of teeth damaged by trauma
•	extraction of teeth as a result of unsuccessful endodontic procedures
•	extraction of mobile teeth secondary to periodontal disease
•	extraction of over-retained primary teeth
•	extraction of teeth for orthodontic purposes
•	suturing of intraoral lacerations less than 2 cm

Miscellaneous:
•	routine treatment planning
•	simple periodontal disease treatment
•	administering nitrous oxide/oxygen analgesia                                                                                           

Questions                              If you have any questions about the information in this bulletin, please   
	contact MassHealth Customer Service at 1-800-841-2900, e-mail your  
	inquiry to providersupport@mahealth.net, or fax your inquiry to  
	617‑988‑8974.
.