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Module 4: Anticipatory Guidance, Fluoride Varnish, and Referral

4.4 Fluoride Varnish Periodicity Schedule

Any infant or child ages 9 months through age 5 who is enrolled in the Maryland Medicaid Program is eligible to receive fluoride varnish application. Under this program, EPSDT medical providers are reimbursed for up to four fluoride varnish applications per year per infant or child. It is required that fluoride varnish be applied in accordance with the Maryland schedule of preventive health care (i.e., during well child visits). The suggested schedule for fluoride varnish application in concert with the Maryland schedule of preventive health care is:

  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • 24 months
  • 30 months
  • 36 months
  • 48 months
  • 60 months

If fluoride varnish is applied after age 6, EPSDT medical providers will not be eligible for reimbursement by the Maryland Medicaid Program. Note: This policy does not affect the reimbursement of fluoride varnish applied in a dental practice. Dentists and dental clinics enrolled as providers in the Maryland Medicaid Program are eligible to seek reimbursement for the application of fluoride varnish for children up to age 21 enrolled in Medicaid.