Medicaid State Plan Amendments

This plan amendment updates procedure codes for rehabilitative clinic and dental services fee schedules.

This amendment proposes to expand the scope of covered dental services that are available to individuals over age 21. Individuals over age 21 will receive the following medically necessary dental services: diagnostic, preventive, restorative, periodontal, prosthodontic, orthodontic, endodontic, emergency dental services, and oral surgery (inpatient and outpatient).

This plan amendment updates and clarifies Fee-For-Service anesthesia services.

This plan amendment updates the bundled composite rate for services provided in an outpatient dialysis clinic.

This plan amendment incorporates provider rate increases and updates the date of the fee schedule for state plan services.

This amendment updates the utilization trend for the outpatient hospital upper payment limit in State Fiscal Year 2025.

The plan amendment rebases and increases Utah’s budget for multiple Fee-For-Service Non-Institutional services.

This plan amendment provides for inflationary increases for certain inpatient hospital service payments.

This plan amendment extends and modifies the Private Hospital Supplemental Fund program for the state fiscal year ending 2025.

This amendment, the state updated the Conflict of Interest (COI) standards section of the SPA to comport with regulatory requirements and expanded the target group criteria to include individuals with any behavioral health condition, substance abuse disorder or brain injury.