Gov. Polis Signs State Budget: CDA Secures Substantial Medicaid Rate Hike for 28 Dental Codes

Becky O'GuinFeatured News, Featured News, Government Relations & Advocacy

Gov. Polis signed the fiscal year 2024/2025 state budget, which will go into effect on July 1, 2024.

Among several important budget inclusions was over $78 million dedicated to meaningful reimbursement rate increases for Medicaid dental providers.

This increase resulted from 18 months of work by the CDA Medicaid Task Force initially chaired by Dr. Carol Morrow in 2022/2023 and then Dr. Jeff Lodl and Dr. Garry Van Genderen in 2023/2024. The task force began its work in the fall of 2022 by investigating and prioritizing Medicaid provider concerns, in addition to comparing Colorado Medicaid rates with the rates in virtually every state in the nation. The task force prioritized the most meaningful rates for patient care and provider recruitment and retention, and testified at numerous hearings to advocate for rates to match the ADA Survey of Dental Fees benchmark.

After well over a year of work, 28 codes were approved for rate increases:

  • 15 preventive, perio and endo codes* were increased to 100% of 2020 ADA Survey of Fees benchmark and
  • 13 diagnostic and crown codes were increased to 70% of 2020 ADA Survey of Fees benchmark.

This is a huge win for access to care in our state thanks to the CDA Medicaid Task Force, CDA Government Relations Council and several key members of the Colorado Joint Budget Committee.

View a list of the 28 codes and reimbursement rates here.

*Scaling/root planing, perio maintenance and endo codes were historically very poorly reimbursed. It is also our goal to increase specialty provider participation with these increases.

In addition, a 2% rate increase will be implemented across all Medicaid provider types starting July 1, 2024.

The 2024 legislative session will adjourn on May 8. Additional information about CDA supported legislation will be available as bills are signed into law by the governor.