Person getting teeth cleaned



The professional fee schedule format lists procedure codes, descriptions, and fee screens. The modifier and age range fields are applicable to the fee screen and do not reflect coverage parameters.  For additional pertinent coverage parameters, such as documentation and billing indicators, refer to the Medicaid Code and Rate Reference tool, which is accessible via the External Links menu within CHAMPS.  Medicaid Code and Rate Reference is an online code inquiry system that provides real-time information for the following:

  • Age restrictions,
  • Diagnoses allowable for Ambulance,
  • Documentation requirements,
  • Frequency limitations,
  • Hospital discharge - Bypass PA
  • NDC information,
  • Prior authorizations and medical conditions that may bypass these requirements,
  • Rate information,
  • Required modifiers,
  • Supplies/DME - per diem, and
  • Tooth number and surface requirements.

To request or view upcoming training sessions please refer to the Michigan Department of Health and Human Services website at>>Training>>Medicaid Provider Trainings.

Any questions should be directed to Provider Inquiry, Michigan Department of Health and Human Services, phone toll-free 800-292-2550 or email at



Fluoride Varnish Certificates for Medicaid Professionals  

Points of Light (POL) Initiative
POL establishes referral mechanisms between medical and dental practices within a community for infant oral health. There is a map of the current POL communities and a search option to find dentists that will examine infants and young children. In addition, there are resources and links to information on infant oral health and community participants.

Infant Oral Health Training and Resource Materials for Medical Providers

On-Line Oral Health Training for Medical Providers