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Dental Managed Care All Plan Letters

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2026 Dental All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 26-0012025-2027 Medi-Cal Dental Managed Care Plan MEDS/834 Cutoff and Processing ScheduleJanuary 27, 2026
APL 26-002Alternative Format Selection for Members with Visual Impairments (Supersedes 22-011)February 3, 2026
APL 26-003Beneficiary Dental Exceptions and Dental Exemption RequestsMarch 17, 2026
APL 26-0042026 Calendar Year (CY) Deliverable Schedule for Dental Managed Care Plans
2026 Deliverable Schedule
April 13, 2026

2025 Dental All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 25-001Disaster Assistance to Evacuated Members and Dental OfficesJanuary 9, 2025

Revised:
February 27, 2025
&
April 22, 2025
APL 25-002Continuity of Care for DMC Members on or after July 1, 2025 (Supersedes APL 17-011E)March 25, 2025

Revised:
May 23, 2025
APL 25-003Transition Policy GuideMarch 25, 2025
APL 25-0042024-2025 Medi-Cal Dental Managed Care Plan MEDS/834 Cutoff and Processing Schedule April 7, 2025
APL 25-0052025 Deliverable Schedule
2025 Deliverable Schedule
April 23, 2025

Revised:
May 6, 2025
APL 25-006Standards for Determining Threshold Languages, Nondiscrimination Requirements, Language Assistance Services, and Alternative Formats (Supersedes APL 21-001)
Threshold and Concentration Language for All Counties
Notice of Nondiscrimination Template
Notice of Availability Template
Statement of Nondiscrimination for Small Sized Notices Template
May 19, 2025
APL 25-007Dental Managed Care (DMC) Plan Member Soft Cap LimitAugust 12, 2025
APL 25-008Grievance and Appeals Reporting Template Update to Align with Centers for Medicare and Medicaid Services (CMS) CategoriesSeptember 30, 2025
APL 25-009Oral Health Performance Measures For Dental Managed Care Contracts Effective July 1, 2025
Attachment A: Performance Measures and Benchmarks
Performance Measures Template
October 10, 2025
APL 25-010Medi-Cal Dental Managed Care Plan Provider Directory UpdatesOctober 17, 2025
APL 25-011Discontinuation of Proposition 56 Tobacco Tax Funds Incentive Supplemental PaymentsOctober 31, 2025
APL 25-012Dental Community Health Worker Services BenefitDecember 29, 2025

Revised:
February 18, 2026

2024 Dental All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 24-001APL 24-001: Modifications to the Grievance and Appeals Deliverable Template For the Medi-Cal Dental Managed Care Program (Supplement APL 22-006)
Grievance and Appeals Template
February 26, 2024
APL 24-002Dental Coverage DisclosuresMay 8, 2024
APL 24-003Medical Loss Ratio Requirements for Subcontractors and Downstream SubcontractorsOctober 10, 2024
APL 24-0042025 Deliverable Schedule
2025 Deliverable Schedule
December 16, 2024
APL 24-005Dental Community Health Worker Services BenefitDecember 19, 2024

2023 Dental All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 23-001Teledentistry Expansion PolicyApril 26, 2023
APL 23-002Cost Avoidance and Post-Payment Recovery for Other Health Coverage
Appendix A: OHC Code Descriptions and Scope of Coverage (COV) Codes Chart
Appendix B: Naming Convention
April 26, 2023
APL 23-0032023 Deliverable Templates (Supersedes APL 14-012)June 8, 2023
APL 23-004Updated Grievance and Appeals Submission Due Date (Supplement APL 22-006)October 20, 2023
APL 23-0052024 Deliverable Schedule (Supersedes APL 22-015)December 21, 2023

2022 Dental All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 22-001Provider Billing PracticesJanuary 28, 2022
APL 22-002Medi-Cal Dental Managed Care Plan Performance MeasuresFebruary 16, 2022
APL 22-003E (Revised)Treatment of Recoveries Made by Managed Care Dental Plans of Overpayments to ProvidersFebruary 16, 2022             Revised: April 20, 2022 
APL 22-004Current Dental Terminology 22June 2, 2022
APL 22-005Fraud, Waste and Abuse ReportingJune 24, 2022
APL 22-006Grievance and Appeals Requirements Notice and “Your Rights” Templates (Supersedes APL 20-003)
APL 22-006 Member Notices:
Notice of Action
  Deny
  Delay
  Modify
  Terminate
  NOA Your Rights (Knox-Keene)
Notice of Appeal Resolution (NAR)
  Overturn
  Uphold
  NAR Your Rights (Knox-Keene)
State Fair Hearing
July 22, 2022
APL 22-007Payment Withhold for Performance Measures, Quality Metrics and Benchmarks (Supersedes APL 16-009)

APL 22-007 Attachment: DMC Performance Measures Quality Metrics and Benchmarks
July 22, 2022
APL 22-008Guidance Regarding AB 1184July 28, 2022
APL 22-009Enforcement Actions: Administrative and Monetary Sanctions (Supersedes APL 13-004)August 19, 2022
APL 22-010Managed Care Program Annual Report (MCPAR)September 30, 2022
APL 22-011Alternate Format Selection for Members with Visual Impairments
Alternate Format Selection Technical Guidance for Medi-Cal Dental Managed Care Plans
Alternate Format Data Process Guide
Alternate Format Selection Application User Guide
September 12, 2022
APL 22-012Continued Supplemental Payment For Certain Dental Services Using Proposition 56 Tobacco Tax FundsOctober 3, 2022
APL 22-013InteroperabilityDecember 1, 2022
APL 22-014Long Term Care IntegrationDecember 23, 2022
APL 22-0152023 Deliverable ScheduleJanuary 3, 2023

2021 Dental All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 21-001Standards for Determining Threshold Languages, Nondiscrimination Requirements, and Language Assistance Services
Threshold and Concentration Languages for All Counties
Notice of Nondiscrimination Template
Taglines Template
May 14, 2021
APL 21-002Dental Managed Care (DMC) Dental Transformation Initiative (DTI) Change Log Clarification
DTI Change Log Template
July 13, 2021
APL_21-003Extension Of One-Year Supplemental Payment For Certain Dental Services Using Proposition 56 Tobacco Tax Funds Allocated For Calendar Year 2021 July 30, 2021
APL 21-004 Current Dental Terminology 21October 18, 2021
APL-21-005CalAIM RequirementsNovember 23, 2021
APL-21-006Calendar Year 2022 Deliverables ScheduleDecember 31, 2021 

2020 Dental All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 20-001Extension of One-Year Supplemental Payment For Certain Dental Services Using Proposition 56 Tobacco Tax Funds Allocated For State Fiscal Year 2019-20February 7, 2020
APL 20-002Continuation of Supplemental Payments For Certain Dental Services Using Proposition 56 Tobacco Tax Funds for July 1, 2020 Through December 31, 2020September 21, 2020

APL 20-003

(Supersedes APL 17-003E) 

Centers For Medicare and Medicaid Services (CMS) Final Rule Revisions Effecting Grievance and Appeal Requirements; Revised “Your Rights” Attachments

Grievance and Appeal Requirements; Revised Notice Templates and “Your Rights” Attachments
APL 20-003 Member Notices:
Notice of Action (NOA)
  Deny/Modify
  Delay
  Revised NOA Your Rights (Knox-Keene)
Notice of Appeal Resolution (NAR)
  Overturn
  Uphold
  Revised NAR Your Rights (Knox-Keene)
1557 Notices
  Language Assistance Taglines
  Nondiscrimination Notice
December 14, 2020
APL 20-0042021 Deliverables ScheduleDecember 23, 2020

2019 Dental All Plan Letters

Letter NumberTitle (Subject) of Letter

Date of Issue

APL 19-001Early and Periodic Screening Diagnostic and Treatment (EPSDT) ServicesJanuary 25, 2019
APL 19-002

Extension of One-Year Supplemental Payment For Certain Dental Services Using Proposition 56 Tobacco Tax Funds Allocated for State Fiscal Year 2018-19

APL 19-002 Attachment: Proposition 56 Directed Payment Report Template (MS Excel)

February 11, 2019
APL 19-003Payment Error Rate Measurement (PERM) Provider UpdateMarch 20, 2019
APL 19-004X12 274 Provider Network Data Reporting Requirements (Supersedes APL 17-010)August 14, 2019

2018 Dental All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 18-001

Revised Grievance and Appeal Report

APL 18-001 Attachment: Quarterly Grievance and Appeal Report Template (MS Excel)

January 3, 2018
APL 18-002APL 18-002 Exhibit A, Attachment 5- Quality Improvement System (Supersedes APL 15-018)January 22, 2018
APL 18-003E (Revised)

Network Adequacy Standards for Timely Access to Care for Routine and Specialist Appointments

APL 18-003 Attachment: DMC Timely Access Template (MS Excel)

January 9, 2018

Revised: 

March 15, 2018

APL 18-004

Provider Screening / Enrollment and Credentialing / Recredentialing

APL 18-004: Frequently Asked Questions (FAQ)

January 16. 2018
APL 18-005Dental Transformation Initiative (DTI) Domain 2 OutreachFebruary 7, 2018
APL 18-006

Modifications to the Performance Measures and Benchmarks for the Medi-Cal Dental Managed Care Program (Supersedes APL 16-017)

APL 18-006 Attachment: DMC Performance Measure Template

March 13, 2018

APL 18-007Requirements for Oral Health AssessmentsJune 15, 2018
APL 18-008Language Access Services for Limited-English Proficient and Non-English Proficient Individuals

May 1, 2018

APL 18-009

Requirements for Use of Non-Monetary Member Incentives

APL 18-009 Attachment: Member Incentive (MI) Program Request for Approval Form

June 22, 2018
APL 18-010Proposition 56 Directed Payment Expenditures for Dental Services for State Fiscal Year 2017-18May 16, 2018
APL 18-011Encounter Data Submission Reconciliation FormJune 25, 2018

2017 Dental All Plan Letters

Letter Number Title (Subject) of LetterDate of Issue
APL 17-001 2017 Deliverables Schedule

January 24, 2017

APL 17-002

Member Handbook and Evidence of CoverageMay 24, 2017

APL 17-003E

Superseded by APL 20-003

Grievance and Appeal Requirements; Revised Notice Templates and “Your Rights” Attachments
APL 17-003 Member Notices:
Notice of Action (NOA)
  Deny/Modify
  Delay
  NOA Your Rights (Knox-Keene)
Notice of Appeal Resolution (NAR)
  Overturn
  Uphold
  NAR Your Rights (Knox-Keene)
  State Hearing Form
1557 Notices
  Language Assistance Taglines
  Nondiscrimination Notice
May 24, 2017
APL 17-004 Prior Authorization for Intravenous Sedation and General Anesthesia ServicesJune 28, 2017
APL 17-005Reminder Regarding Requirement to Submit Specialty Referrals Report

July 28, 2017

APL 17-007 One-Year Supplemental Payment Using Proposition 56 Tax FundsNovember 21, 2017
APL 17-008 Network Adequacy Standards for Time and Distance

November 8, 2017

APL 17-009

Full Restoration of Adult Dental Benefits for the Medi-Cal Dental Managed Care Program

November 27, 2017

APL 17-010Plan Provider Network and Changes to Plan Provider NetworkDecember 1, 2017

APL 17-011E

Transition of Care Policy

December 18, 2017

Revised:

April 5, 2018

APL 17-0122018 Deliverables ScheduleDecember 27, 2017

2016 Dental All Plan Letters

Letter Number Title (Subject) of LetterDate of Issue
APL 16-001 Due Dates for All Dental Managed Care Contracts for Calendar Year 2016January 14, 2016
APL 16-002 Discontinuation of Website Posting for All Plan LettersJanuary 29, 2016
APL 16-005 Registered Dental Hygienists in Alternative Practice Policy AmendmentsJanuary 20, 2016
APL 16-009 Waiver of the Capitation Payment Withhold for Performance Measures and BenchmarksAugust 1, 2016
APL 16-010 Final Rule Notice of Modernized Managed Care Regulation 42 C.F.R. § 438.706: Special Rules for Temporary Management Effective July 5, 2016January 20, 2017
APL 16-011 Final Rule Notice of Modernized Managed Care Regulation 42 C.F.R. § 438.710: Notice of Sanction and Pre-Termination HearingJanuary 20, 2017
APL 16-013 Final Rule Notice of Modernized Managed Care Regulation 42 C.F.R. § 438.2: General Provisions, Definitions Effective July 5, 2016January 20, 2017
APL 16-014Final Rule Notice of Modernized Managed Care Regulations: 42 C.F.R. § 438.3 (d) Standard Contract Requirements and 42 C.F.R. § 440.262 Access and Cultural ConsiderationsJanuary 20, 2017
APL 16-016

Emergency Dental Services

September 9, 2016
APL 16-017Performance Measure ImplementationOctober 14, 2016
APL 16-019 Final Rule Notice of Modernized Managed Care Regulation 42 C.F.R. § 438.50: Public Health, Regulation, State Plan RequirementsJanuary 20, 2017
APL 16-020Final Rule Notice of Modernized Managed Care Regulation 42 C.F.R. § 438.3(f): Compliance with Applicable Laws and Conflicts of Interest SafeguardsJanuary 19, 2017

2015 Dental All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 15-002Department of Health Care Services Policy Updates Regarding Aggregate Data ReportingMarch 27, 2015
APL 15-003Participation of Allied Dental Professionals in the Dental Managed Care ProgramMay 20, 2015
APL 15-004Clarification on Exhibit A, Attachment 3: Financial InformationMarch 12, 2015
APL 15-005 Prior Authorization for Intravenous Sedation and General Anesthesia ServicesApril 1, 2016
APL 15-006Virtual Dental Home Implementation n the Dental Managed Care ProgramJune 1, 2015
APL 15-007Transition to Post Adjudication Claims and Encounter Data Systems (PACES)May 21, 2015
APL 15-009Modifications to the Performance Measures and Benchmarks for the Medi-Cal Dental Managed Care ProgramOctober 9, 2015
APL 15-014Approval Process for Annual Rates Packages and Rate AdjustmentsSeptember 15, 2015
APL 15-015Update Regarding Virtual Dental Home Implementation in the Dental Managed Care ProgramSeptember 2, 2015
APL 15-016 Increased Frequency Limitations for Certain Preventative Services for Beneficiaries Residing in Skilled Nursing Facilities and Intermediate Care FacilitiesNovember 24, 2015
APL 15-018 Quality Improvement Projects Guidelines and ScheduleNovember 24, 2015
APL 15-019 Modification of Adjudication Criteria for D0145December 2, 2015

2014 Dental All Plan Letters 

Letter NumberTitle (Subject) of LetterDate of Issue
APL 14-001Revised: Due Dates for All Dental Managed Care Contracts for Calendar Year 2014August 14, 2014
APL 14-002Revised: Notice of Changes Regarding Adult Dental Services at Federally Qualified Health Centers and Rural Health Clinics and the Restoration of Some Adult Dental BenefitsAugust 19, 2014
APL 14-003Update Regarding the Restoration of Some Adult Dental Services Effective May 1, 2014May 16, 2014
APL 14-004Consumer Satisfaction SurveyJuly 23, 2014
APL 14-007 Clarification on Exhibit A, Attachment 5, Provision L, to Include Requirements to Comply with the Program Integrity Provisions of 42 Code of Federal RegulationsAugust 25, 2014
APL 14-008Expanded Services for Pregnant Beneficiaries Effective May 1, 2014August 14, 2014
APL 14-009Comprehensive Services for Pregnant Beneficiaries Effective October 1, 2014October 1, 2014
APL 14-010County Specific Benchmarks Effective January 1, 2013 for Geographic Managed Care and July 1, 2013 for Prepaid Health PlanJanuary 30, 2015
APL 14-012Updated Performance Measures and Benchmarks Deliverable TemplateOctober 21, 2014
APL 14-014 Due Dates for All Dental Managed Care Contracts for Calendar Year 2015January 9, 2015
APL 14-017 Requirements for Coverage of Early and Periodic Screening, Diagnostic, and Treatment Services for Medi-Cal Beneficiaries Under the Age of Twenty OneDecember 12, 2014

 2013 Dental All Plan Letters 

Letter NumberTitle (Subject) of LetterDate of Issue
APL 13-000Implementation Deliverable Requirements and Due Date for the GMC PlansJanuary 11, 2013
APL 13-001Due Dates for All Deliverables for Calendar Year 2013January 1, 2013
APL 13-002Minimum Loss Ration ClarificationJanuary 1, 2013
APL 13-004Clarification on Exhibit A, Attachment 5: Provision N – Corrective Action Plan January 1, 2013
APL 13-005Clarification on Exhibit A, Attachment 6: Performance Measures and BenchmarksJanuary 1, 2013
APL 13-006Clarification on Exhibit A, Attachment 7: Utilization ManagementJanuary 1, 2013
APL 13-007Clarification on Exhibit A, Attachment 9: Provision B – Provider GrievancesJanuary 1, 2013
APL 13-008Clarification on Exhibit A, Attachment 10: Provision F – Federally Qualified Health Centers, Rural Health Clinics; and Indian Health Service FacilitiesJanuary 1, 2013
APL 13-009Clarification on Exhibit A, Attachment 11: Provision B and H – Sub-provision 3 & 5, Timely Access, and Linguistic ServicesJanuary 1, 2013
APL 13-010Clarification on Exhibit A, Attachment 17: Provision C – Marketing PlanJanuary 1, 2013
APL 13-011Clarification on Delivery Methods and DHCS ContactsJanuary 1, 2013
APL 13-012Healthy Families Reporting Aid Codes and Due DateFebruary 14, 2013
APL 13-013Deliverables for Exhibit A, Attachment 12: Provision D – Health EducationMarch 1, 2013
APL 13-014Clarification on Exhibit A, Attachment 9: Provision E – Provider TrainingMarch 1, 2013
APL 13-015Dental Managed Care Rates for 2013April 26, 2013
APL 13-016 Implementation Deliverable Requirements and Due Date for the PHP PlansJune 13, 2013
APL 13-017Some Adult Dental Services to be Restored May 1, 2014October 4, 2013
APL 13-018Dental Managed Care Revised Rates for 2013September 13, 2013
APL 13-021Insure Kids Now WebsiteOctober 16, 2013
APL 13-022Due Dates for All PHP Deliverables for Calendar Year 2013-2014November 19, 2013
APL 13-023Implementing a new Encounter Data Capture and Transmission SystemDecember 17, 2013