23 MAC Pt. 204, R. 2.1
Simple Extractions
Cite as 23 Miss. Admin. Code Pt. 204, R. 2.1
Simple Extractions
Medicaid covers for simple extractions and the fee includes local anesthesia and routine post-
operative care.
A. Medicaid covers for alveoloplasties with the simple extraction of three (3) or more adjacent
teeth in the same quadrant.
B. Medicaid requires for an alveolopasty by quadrant to be covered, a minimum of five (5) teeth
in the quadrant must be done.