Medicaid

Children and adolescents under age 21 have no annual maximum. Adults age 21 and older and pregnant women age 21 and older have a $1,000 annual maximum per member per calendar year (January 1 through December 31). Covered preventive cleanings, exams, direct restorations (fillings), crowns, and periodontal treatments apply toward that limit. Additional benefits beyond $1,000 may be authorized under prior authorization on the basis of documented medical necessity for critical adjacent/abutment teeth supporting a partial denture.

If you are enrolled in managed care, your dental benefits are administered through LIBERTY Dental Plan. If you have fee-for-service coverage, benefits are administered directly through Nevada Medicaid (DHCFP). The MCO listed on your medical Medicaid card (for example Anthem, SilverSummit, or Molina) does not administer the dental benefit directly.

Managed care members can use the LIBERTY Dental Plan of Nevada portal at client.libertydentalplan.com/NVMedicaid or call 1-888-401-1129. Fee-for-service members can use the Nevada Medicaid portal at medicaid.nv.gov or call customer service at 1-877-638-3472.

Bring your Nevada Medicaid identification card, your Medicaid MCO card if one was issued, your LIBERTY Dental Plan member card or digital ID if available, a photo ID when requested by the office, and proof of pregnancy documentation if you are using expanded pregnancy-related benefits.

Root canal therapy requires prior authorization (PA 01 for pregnant women) and is not covered for adults under the standard benefit. Fillings, prefabricated crowns, and core buildups on adult abutment teeth require adult PA 02. Complete and partial dentures require a narrative and X-rays. Sedation is subject to setting review and clinical criteria. Exams, X-rays, cleanings, fluoride, sealants, space maintainers, pulpotomies, extractions, and emergency palliative care do not require prior authorization.

Yes. Emergency palliative pain relief is covered 1 per day and 2 every 6 months for children, adults, and pregnant women, with no prior authorization. Simple extractions are covered as clinically needed (subject to criteria for adults), and surgical or impacted extractions are covered with a narrative and X-rays.

Not under the standard adult benefit. Root canal therapy, topical fluoride, dental sealants, space maintainers, and pulpotomies are not covered for adults age 21 and older. Children under 21 and pregnant women do have these benefits, with root canal therapy limited to 1 per tooth in a lifetime and requiring prior authorization.

Complete dentures and partial dentures (resin or cast base) are covered 1 per arch every 60 months for children, adults, and pregnant women. A narrative and X-rays are required.

No. Medicaid dental benefits vary by eligibility category and may change. Coverage depends on current eligibility, benefit category, age, pregnancy status, frequency limitations, clinical criteria, documentation, authorization requirements, and applicable benefit maximums. Please confirm current eligibility and benefits before treatment. Official Nevada Medicaid and LIBERTY Dental Plan determinations control if they differ from this summary.