Measures Not Included in PCDH Framework

Not applicable

Utilization: Use of any dental or oral health service

Enter the unduplicated number of individuals under the age of 21 with at least 90 continuous days of enrollment during the federal fiscal year who received either a "dental service" by or under the supervision of a dentist or an "oral health service" by a qualified health care practitioner who is neither a dentist nor providing services under the supervision of a dentist, based on an unduplicated paid, unpaid, or denied claim. Numerator: Unduplicated number of individuals who received either a "dental service" by or under the supervision of a dentist or an "oral health service" by a qualified health care practitioner who is neither a dentist nor providing services under the supervision of a dentist, based on an unduplicated paid, unpaid, or denied claim. An individual should be counted only once on this line regardless of how many dental services and oral health services he or she received during the reporting period. Denominator: Total unduplicated number of individuals under the age of 21 who have been continuously enrolled in Medicaid or a CHIP Medicaid expansion program for at least 90 continuous days in the federal fiscay yhear and determined to be eligible for EPSDT services, distributed by age and by basis of eligibility.

Measure

Children

Administrative enrollment and claims data

CMS 416 Measures; DQA Starter Set Measures Environmental Scan (2012); NQF Environmental Scan (2012)

Centers for Medicare & Medicaid Services (CMS)

CMS EPSDT Reporting