APA WF # 25-11 Dental Policy Revisions

The proposed policy changes are being promulgated as Permanent Rules.

The proposed policy changes update dental imaging requirements to reflect the current standard of care and ensure appropriate billing for complex extractions. Current OHCA policy defines a “full mouth series” as two bitewings and panoramic images. The revision clarifies that a compensable full mouth series consists of at least 10 periapical images and at least 2 posterior bitewings, consistent with current dental practice. The changes also establish a prior authorization requirement for complex extractions (CDT codes D7210 and D7250) when more than two are performed on the same date of service by a provider other than an oral surgeon. Complex extractions performed by an oral surgeon are covered without prior authorization. There are no changes to policy or billing expectations for simple extractions (CDT code D7140).

Please view the draft regulatory text here and submit feedback via the comment box.

Please view the rule impact statement here.

Proposed Policy Timeline

Circulation Date: 12/15/2025

Medical Advisory Committee: 1/8/2026

Comment Due Date: 1/15/2026

Public Hearing: 1/15/2026

Board Meeting: 1/21/2026

After you submit your comment, you should be re-directed to a confirmation page. If you are not, please submit your comment through e-mail to federal.authorities@okhca.org.

Please note that all comments must be reviewed and approved prior to posting. Approved comments will be posted Monday through Friday between the hours of 7:30 a.m. – 4 p.m. Any comments received after 4 p.m. will be posted on the following business day.