Impact of Medicaid Expansion on State-Level Medicaid Reimbursement for Orthodontia in Patients With Cleft Lip and Palate: A Cost Analysis.

Objective : Examine state-level Medicaid reimbursement rates after Medicaid expansion for Phase I and II orthodontia relevant to patients with cleft lip and palate. Design : Cross-sectional study of publicly available 2024 state Medicaid reimbursement rates associated with Phase I and II orthodontia...

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Publicado en:Cleft Palate Craniofacial Journal Vol. 63; no. 3; pp. 422 - 429
Autores principales: McCall, Ronald Rae, Elver, Ashlie A, Pitre, Kendall C, Hoppe, Ian C, Humphries, Laura S
Formato: pictorial research tables/charts Journal Article
Publicado: Sage Publications Inc. Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
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        atl: Impact of Medicaid Expansion on State-Level Medicaid Reimbursement for Orthodontia in Patients With Cleft Lip and Palate: A Cost Analysis.
      aug:
        au:
          McCall, Ronald Rae
          Elver, Ashlie A
          Pitre, Kendall C
          Hoppe, Ian C
          Humphries, Laura S
        affil: School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
      sug:
        subj:
          Cleft Lip Surgery
          Cleft Palate Surgery
          Orthognathic Surgery
          Medicaid Expansion United States
          Orthodontics Economics
          Insurance, Health, Reimbursement Evaluation
          Health Care Costs
          Human
          Cross Sectional Studies
          Fee for Service Plans
          United States
          One-Way Analysis of Variance
          T-Tests
          Health Services Accessibility
          Income
          Treatment Delay Risk Factors
          Risk Assessment
          Poverty
          Cost of Living
          Pediatric Care
          Socioeconomic Factors
          Interinstitutional Relations
          Health Policy
          Descriptive Statistics
          Data Analysis Software
      ab: Objective : Examine state-level Medicaid reimbursement rates after Medicaid expansion for Phase I and II orthodontia relevant to patients with cleft lip and palate. Design : Cross-sectional study of publicly available 2024 state Medicaid reimbursement rates associated with Phase I and II orthodontia. One-Way ANOVA and independent t-tests compared regional and Medicaid expansion groups. Setting : National sample of Medicaid reimbursement fee schedules. Patients : Fifty US states, including DC, utilizing fee-for-service reimbursement for Medicaid enrollees. Main Outcome Measure(s) : Reimbursement Rates for CPT Code D8020 (Phase I: Limited Orthodontia, Transitional Dentition) and D8080 (Phase II: Comprehensive Orthodontia, Adolescent Dentition) were compared between regions and by Medicaid expansion status. Results : Ten states did not adopt Medicaid Expansion (19.6%: AL, FL, GA, KS, MS, SC, TN, TX, WI, and WY). Coverage of Phase I care was low overall (58.5% of expanded and 55.6% of non-expanded states), with average reimbursement of $1080.13. More states offered Phase II coverage (87.8% of expanded and 77.8% of non-expanded states). Phase II reimbursement was higher in expansion states ($2596.73 ± $2252.59 vs non-expansion: $1266.78 ± $314.19; P =.001). The South trended toward higher reimbursement for Phase II ($3224.95; P =.093), followed by the West ($2902.88 ± 1327.40 vs $1413.26-$1699.10). Conclusions : Provider reimbursement influences access to orthodontia. Although Medicaid expansion aims to improve access for low-income families, gaps in orthodontic coverage persist. Despite higher Phase II reimbursement in Southern and expansion states, inadequate Phase I coverage and low reimbursement schedules limit provider participation, leaving low-income patients with clefts at risk for delayed or absent orthodontia and thus suboptimal outcomes.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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