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The Role of Medical Providers

Key Points

  • Medical providers and staff see young children earlier and more frequently than oral health providers and play a key role in establishing optimal oral health.
  • The American Academy of Pediatrics recommends that by age 6 months every child should receive an oral health risk assessment conducted by a qualified pediatrician or a qualified pediatric health professional.
  • To receive reimbursement for a fluoride varnish application, providers must (1) be EPSDT-certified physicians, physician assistants, or nurse practitioners licensed to practice in Maryland; (2) participate in the Maryland Medicaid Program, and provide services in accordance with the rules and regulations of the program; and (3) successfully complete the fluoride varnish curriculum post-tests with at least 80 percent accuracy.
  • Medical extenders may apply fluoride varnish if they are (1) working under the supervision of an EPSDT-certified physician, physician assistant, or nurse practitioner licensed to practice in Maryland and (2) legally allowed to administer medical immunizations in Maryland.
  • Medical extenders are not eligible to seek reimbursement for the application of fluoride varnish under Maryland’s Medicaid Program; only their EPSDT-certified physician, physician assistant, or nurse practitioner employer can bill under this program.
  • When an EPSDT medical provider successfully completes this course, Maryland’s Department of Health, Office of Oral Health, will notify the Maryland Medicaid Program and Scion that the provider has completed the course.