Definitions

The following terms used in 130 CMR 420.000 have the meanings given in 130 CMR 420.402, unless the context clearly requires a different meaning. The reimbursability of services defined in 130 CMR 420.000 is not determined by these definitions, but by application of 130 CMR 420.000 and 450.000: Administrative and Billing Regulations. Definitions specific to radiographs are set forth at 130 CMR 420.423. Adult Dentition (Permanent Dentition). Permanent teeth that have erupted and replaced deciduous teeth. Benefit Year. The start date of Benefit Year 2027 shall be identified in MassHealth written issuance. The end date of the Benefit Year 2027 is June 30, 2027. Subsequent Benefit Years are July 1 through June 30 (e.g., Benefit Year 2028 is July 1, 2027, through June 30, 2028). BORID. The Board of Registration in Dentistry, or any committee or subcommittee thereof, established in the Massachusetts Department of Public Health (DPH) pursuant to the provisions of M.G.L. c. 13, §19 and c. 112 §§1, 12CC, 43 through 53, and 61 through 65E. Caseload Capacity. A MassHealth dental provider’s good-faith determination of the number of MassHealth members to whom the provider is able to provide dental services. CODA. The Commission on Dental Accreditation of the American Dental Association. Department of Developmental Services (DDS). The state agency organized under M.G.L. c. 19B. DDS Clients. MassHealth members 21 years of age or older who have been determined by DDS to be eligible for adult DDS services, pursuant to 115 CMR 6.00: Standards to Promote Dignity. EPSDT. Early and Periodic Screening, Diagnostic and Treatment Services as described in federal law at 42 U.S.C. §§1396d(a)(4)(B) and 1396d(r) and 42 CFR 441 Subpart B. In Massachusetts, EPSDT-eligible members are in MassHealth Standard or MassHealth CommonHealth categories of assistance and are younger than 21 years old. Mobile Dental Facility (MDF). Any self-contained facility where dentistry will be practiced that may be driven, moved, towed, or transported from one location to another. Portable Dental Operation (PDO). Any dental practice where a portable dental unit is transported to and utilized on a temporary basis at an out-of-office location. Primary Dentition (Deciduous Dentition). Deciduous teeth developed and erupted first in order of time. Public Health Setting. Includes, but is not limited to, residences of the homebound; schools; Head Start programs; nursing homes and long-term care facilities licensed pursuant to M.G.L. c. 111, § 71; clinics, community health centers, and hospitals licensed pursuant to M.G.L. c. 111, § 51; medical facilities; residential treatment facilities; federal, state or local public health programs; MDFs and portable dental programs which are permitted by BORID pursuant to 234 CMR 7.00: Mobile and Portable Dentistry or licensed or certified by DPH pursuant to M.G.L. c. 111, § 51; and other facilities or programs deemed appropriate by BORID or DPH. Transitional Dentition (Mixed Dentition). The phase of the transition from Primary Dentition to Permanent Dentition, in which growth has not ceased and the deciduous teeth are in the process of shedding and the permanent successors are emerging.