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Are fluoride treatments (also known as fluoride varnishes) eligible for the one percentage point increase

No, fluoride varnish is not eligible for the one percentage point FMAP increase. In the future, if the United States Preventive Services Task Force (USPSTF) adds fluoride varnish to the A or B recommended preventive services, states will be required to cover the fluoride varnish with no cost-sharing. Per State Medical Director (SMD) letter #13-002, states should provide an assurance in the state plan indicating they have a method to ensure that, as changes are made to the USPSTF and the Advisory Committee on Immunization Practices (ACIP) recommendations, they will update their coverage and billing codes to comply with those revisions. As long as this assurance is in the state plan, states are not required to submit a state plan amendment each time the USPSTF or ACIP makes changes to their recommendations.

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Date
FAQ ID
91536
FAQ Question
Are fluoride treatments (also known as fluoride varnishes) eligible for the one percentage point increase in federal medical assistance percentage (FMAP) under section 4106 of the Affordable Care Act?