Dental Fee Schedule Page


ADA LICENSE AGREEMENT FOR USE OF CDT CODES The dental procedure codes, nomenclatures, and descriptors included in these documents have been obtained or appears verbatim from the Current Dental Terminology (CDT) – 2012/2013. CDT (including procedures codes, definitions (descriptors) and other data) is copyrighted by the American Dental Association. ©2012 American Dental Association. All rights reserved. Applicable FARS/DFAES apply.

Fee Schedules for Adult Denture, EPSDT, and Expanded Dental Services for Pregnant Women (EDSPW) programs for given dates of service.

Fee Schedules Description
Adult Denture Program
Adult Denture Program Fee Schedule for Dates of Service August 1, 2013 through present (PDF Format) *Current* Fee Schedule for the Louisiana Medicaid Adult Denture Program for the given dates of service.
Adult Denture Program Fee Schedule for Dates of Service July 1, 2012 through July 31, 2013 (PDF Format) Fee Schedule for the Louisiana Medicaid Adult Denture Program for the given dates of service.
Adult Denture Program Fee Schedule for Dates of Service November 1, 2007 through June 30, 2012 (PDF Format) Fee Schedule for the Louisiana Medicaid Adult Denture Program for the given dates of service.
Adult Denture Program Fee Schedule for Dates of Service November 1, 2006 through October 31, 2007 (PDF Format) Fee Schedule for the Louisiana Medicaid Adult Denture Program for the given dates of service.
Adult Denture Program Fee Schedule for Dates of Service August 1, 2003 through October 31, 2006 (PDF Format) Fee Schedule for the Louisiana Medicaid Adult Denture Program for the given dates of service.
EPSDT Dental Program
EPSDT Dental Program Fee Schedule for Dates of Service August 1, 2013 through present (PDF Format) *Current*Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service January 1, 2013 through July 31, 2013 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service July 1, 2012 through December 31, 2012 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service January 1, 2011 through June 30, 2012 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service August 1, 2010 through December 31, 2010 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service January 22, 2010 through July 31, 2010 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service January 1, 2009 through January 21, 2010 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service December 24, 2008 through December 31, 2008 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service November 1, 2007 through December 24, 2008 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service January 1, 2007 through October 31, 2007 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service November 1, 2006 through December 31, 2006 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EPSDT Dental Program Fee Schedule for Dates of Service November 1, 2005 through October 31, 2006 (PDF Format) Fee Schedule for the Louisiana Medicaid EPSDT Dental Program for the given dates of service.
EDSPW Dental Program
EDSPW Program Fee Schedule for Dates of Service July 1, 2012 through January 31, 2013 (PDF Format) Fee Schedule for the Louisiana Medicaid EDSPW Program for the given dates of service.
EDSPW Dental Program Fee Schedule for Dates of Service January 1, 2011 through June 30, 2012 (PDF Format) Fee Schedule for the Louisiana Medicaid EDSPW Program for the given dates of service.
Expanded Dental Services for Pregnant Women (EDSPW) Program Fee Schedule for Dates of Service August 1, 2010 through December 31, 2010 (PDF Format) Fee Schedule for the Louisiana Medicaid EDSPW Program for the given dates of service.
Expanded Dental Services for Pregnant Women (EDSPW) Program Fee Schedule for Dates of Service January 22, 2010 through July 31, 2010 (PDF Format) Fee Schedule for the Louisiana Medicaid EDSPW Program for the given dates of service.
Expanded Dental Services for Pregnant Women (EDSPW) Program Fee Schedule for Dates of Service January 6, 2009 through January 21, 2010 (PDF Format) Fee Schedule for the Louisiana Medicaid EDSPW Program for the given dates of service.
Expanded Dental Services for Pregnant Women (EDSPW) Program Fee Schedule for Dates of Service November 1, 2007 through January 5, 2009 (PDF Format) Fee Schedule for the Louisiana Medicaid EDSPW Program for the given dates of service.
Expanded Dental Services for Pregnant Women (EDSPW) Program Fee Schedule for Dates of Service November 1, 2006 through October 31, 2007 (PDF Format) Fee Schedule for the Louisiana Medicaid EDSPW Program for the given dates of service.
Expanded Dental Services for Pregnant Women (EDSPW) Program Fee Schedule for Dates of Service November 1, 2005 through October 31, 2006 (PDF Format) Fee Schedule for the Louisiana Medicaid EDSPW Program for the given dates of service.