Agencies
Services
Provider Notice Issued 11/22/2021
Date: November 22, 2021
To: Enrolled Dentists
Re: Dental Service Rate Update Effective for Dates of Service on and after January 1, 2022
________________________________________________________________________________________________________
This notice informs dental providers that the Department is updating dental services' rates effective with dates of service beginning January 1, 2022, to comply with Public Act 102-0016 and
Public Act 102-0043. The rates apply to services provided under both traditional fee-for-service, Medicaid HealthChoice Illinois managed care plans, and the Medicare-Medicaid Alignment Initiative (MMAI).
The table below identifies the affected dental codes with rate increases:
| CDT Code | New Rate | CDT Code | New Rate | CDT Code | New Rate |
| D0140 | $19.12 | D2160 | $75.47 | D5110 | $444.09 |
| D0150 | $24.84 | D2161 | $75.47 | D5120 | $444.09 |
| D0210 | $35.52 | D2330 | $44.98 | D7140 | $46.16 |
| D0220 | $6.61 | D2331 | $67.47 | D7210 | $67.73 |
| D0230 | $4.48 | D2332 | $80.34 | D9222 | $214.00 |
| D0272 | $11.09 | D2335 | $80.34 | D9223 | $214.00 |
| D0274 | $19.94 | D2391 | $36.40 | D9230 | $46.55 |
| D0330 | $26.67 | D2392 | $56.82 | D9239 | $181.00 |
| D1110 | $48.38 | D2393 | $75.47 | D9243 | $181.00 |
| D2140 | $36.40 | D2394 | $75.47 | D9248 | $150.00 |
| D2150 | $56.82 | D2930 | $95.42 |
The Dental Fee Schedule has been updated. Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service issues, or to the applicable HealthChoice Illinois managed care plan.
Kelly Cunningham, Administrator
Division of Medical Programs