Kev soj ntsuam kev pheej hmoo Caries
Rov qab mus rau CalAIM Dental Homepage
Qhov kev pib CalAIM no tau ntxiv cov Caries Risk Assessment (CRA) pob los ua cov txiaj ntsig kho hniav tshiab hauv kev ua raws li cov qauv kev kho hniav hauv teb chaws. Lub hom phiaj tag nrho ntawm qhov txiaj ntsig tshiab no yog txhawm rau txheeb xyuas thiab tswj kev pheej hmoo ntawm kab mob caries thiab hais txog kev muab kev pabcuam tiv thaiv los ntawm kev cuam tshuam ntau dua thiab raug nqi rau cov menyuam hnub nyoog 0-6 xyoo. Cov txiaj ntsig no muaj nyob thoob plaws lub xeev thiab tso cai rau cov chaw muab kev pabcuam, suav nrog cov kws kho hniav sib koom ua ke, sau nqi rau CRA pob nqi suav nrog kev tso cai nce ntau zaus rau qee cov kev pabcuam tiv thaiv rau cov neeg uas muaj kev pheej hmoo siab caries.
The CRA bundle consists of either D0601, D0602, or D0603 (CRA exams at low, moderate, and high risk) and D1310 (nutritional counseling). The bundle’s rate of payment, also known as the Schedule of Maximum Allowances (SMA) fee, is $61, with $15 being assigned to codes D0601-D0603 and $46 being assigned to D1310. The risk level associated with a specific patient determines billing limitations for that bundle. Based on the risk level associated with each Medi-Cal member (ages 0-6), the following frequency of services applies:
- Tsawg Risk - Tus kws kho mob tuaj yeem sau nqi rau CRA pob (CDT code D0601 thiab D1310) nrog rau cov kev pabcuam tiv thaiv ntxiv xws li ntxuav lossis tshuaj fluoride (D0120, D1120, D1206, D1208) ob zaug hauv ib xyoos
- Kev pheej hmoo nruab nrab - Tus kws kho mob tuaj yeem sau nqi CRA pob (D0602 thiab D1310) nrog rau cov kev pabcuam tiv thaiv ntxiv xws li kev ntxuav lossis tshuaj fluoride (D0120, D1120, D1206, D1208) peb zaug hauv ib xyoos.
- Kev pheej hmoo siab - Cov kws kho mob tuaj yeem sau nqi CRA pob (D0603 thiab D1310) nrog rau cov kev pabcuam tiv thaiv ntxiv xws li kev ntxuav lossis tshuaj fluoride (D0120, D1120, D1206, D1208) plaub zaug hauv ib xyoos.
To receive payment for the CRA bundle benefit, dental providers must take the Treating Young Kids Everyday (TYKE) training hosted by the California Dental Association or Strengthening Many Young Lives Everyday (SMYLE) training available on Medi-Cal Dental’s Learning Management System (LMS). Fee-For-Service (FFS) providers must provide an attestation form and proof of course completion to the Dental Administrative Services Organization (ASO) before payment will be rendered for CRA services. DMC and SNC providers must keep an attestation form and proof of course completion on file for auditing purposes. Rendering providers who have already taken the TYKE training under Domain 2 of Dental Transformation Initiative are not required to re-take the TYKE training under CalAIM.