Dental Transformation Initiative Domain 3 Resources
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This domain aims to improve the continuity of dental care for children in Medi-Cal. Incentive payments will be awarded to dental providers in select counties who have maintained continuity of care through providing examinations for their enrolled children ages 20 and under. The goal is to Increase continuity of care for beneficiaries ages 20 and under for 2, 3, 4, 5, 6, and 7 continuous years.
On January 1, 2019, Domain 3 expanded from 17 to 36 pilot counties. The added counties became effective beginning in program year 4. Additionally, Domain 3 annual incentive payment amounts increased by $60 per beneficiary with dates of service of January 1, 2019 or later. The revised payment scale with a $60 increase was reflected in the June 2020 incentive payment and will be reflected in the June 2021, August 2022, and July 2023 incentive payments. The next annual Domain 3 payment will occur July 2023.
The established pilot counties are:
*Additional counties effective January 1, 2019
The counties selected do not offer dental managed care, so only enrolled Medi-Cal Dental providers in the Medi-Cal Dental Fee-For-Service (FFS) delivery system including Safety Net Clinics (e.g., Federally Qualified Health Centers; Rural Health Clinics; and Indian Health Services/Memorandum of Agreement Clinics (community health centers)) in the selected counties may participate in this Domain. Enrolled FFS Medi-Cal Dental providers in the selected counties are not required to take any action to participate in this Domain. However, Safety Net Clinics must submit an Opt-in Form to participate and transmit their claims data using the instructions below.
Safety Net Clinic Resources for Data Submission
The claim submission deadlines for Domain 3 are June 1, 2023 for proprietary claims and June 21, 2023 for electronic claims. Providers must submit all DTI related claims for calendar year 2021 by these dates for payment consideration. Claims submitted after these dates may not be considered for payment. All payments are subject to authorized funding authority.
Note: DHCS encourages SNCs to submit claims electronically, rather than via proprietary form. Please see the encounter data submission process for SNCs below.
Contact Us
Please direct your comments, questions, or suggestions regarding the DTI to the following email address: DTI@dhcs.ca.gov.
