The orthodontic scoring tool within the Illinois Medicaid program has updated its rules and scoring criteria.
The update is in part due to the Illinois State Dental Society’s work during the 2024 legislative session to secure $12 million in funding to modernize the tool and improve access to orthodontic care, according to a March 27 news release from the ISDS.
The updates apply retroactively to Jan. 1, 2025.
Here is the updated scoring tool.
Automatic qualifiers now include the following conditions:
Cleft palate or other craniofacial anomalies
Deep impinging bite with signs of tissue damage, not just touching palate
Anterior crossbite with gingival recession
Severe traumatic deviation
Overjet of 9mm or greater
Impacted teeth where eruption is impeded but extraction is not indicated
Source: Illinois Medicaid orthodontic scoring tool updated / Becker’s Dental + DSO Review