# 89 Ill. Adm. Code 1400.140.421: Section 140.421 Limitations on Dental Services > Illinois · Regulations · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_421 ## Section - **Citation:** 89 Ill. Adm. Code 1400.140.421 - **Heading:** Section 140.421 Limitations on Dental Services - **Jurisdiction:** Illinois - **Kind:** Regulations - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Illinois Administrative Code / Title 89 / / Part 1400 / Section 140.421 Limitations on Dental Services ## Text Section 140 TITLE 89: SOCIAL SERVICES CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES SUBCHAPTER d: MEDICAL PROGRAMS PART 140 MEDICAL PAYMENT SECTION 140.421 LIMITATIONS ON DENTAL SERVICES Section 140.421  Limitations on Dental Services Effective for dates of service on or after July 1, 2018: a)         The Department shall impose prior approval requirements to determine the medical necessity of dental services listed in this Section. Prior approval is required for: 1)         Crowns; 2)         Partial Pulpotomy; 3)         Periodontal services, except full mouth debridement for diagnostic purposes; 4)         Apexification and recalcification; 5)         Apicoectomy; 6)         Dentures, partial dentures and denture relines; 7)         Maxillofacial prosthetics; 8)         Prosthodontics; 9)         Removal of impacted teeth; 10)         Surgical removal of residual roots; 11)         Surgical exposure to aid eruption; 12)         Alveoloplasty; 13)         Incision and drainage of abscess; 14)         Removal of cysts or tumors; 15)         Frenulectomy; 16)         Orthodontics. Effective January 1, 2017, medically necessary orthodontic treatment is approved only for patients under the age of 21 and is defined as: A)        Treatment necessary to correct a condition that scores 28 points or more on the Handicapping Labio-Lingual Deviation Index (HLD); B)        Treatment necessary to correct the following conditions, effective January 1, 2025: i)          Cleft palate or other craniofacial anomalies; ii)         Deep impinging bite with signs of tissue damage, not just touching palate; iii)        Anterior crossbite with gingival recession; iv)        Severe traumatic deviation (i.e., accidents, tumors, etc.; attach description); v) Overjet of 9mm or greater or ; vi)        Impacted teeth where eruption is impeded but extraction is not indicated eft palate or other craniofacial anomalies; ii)         Deep impinging bite with signs of tissue damage, not just touching palate; iii)        Anterior crossbite with gingival recession; iv)        Severe traumatic deviation (i.e., accidents, tumors, etc.; attach description); v) Overjet of 9mm or greater or ; vi)        Impacted teeth where eruption is impeded but extraction is not indicated. C)        Effective January 1, 2025, if a prior authorization request for orthodontic treatment is denied, the provider who submitted the request shall be provided with the HLD scoring tool and the HLD score that prompted denial of the request. 17)         General anesthesia, conscious sedation or deep sedation; 18)         Therapeutic drug injection; 19)         Other drugs and medicaments; 20)         Unspecified miscellaneous adjunctive general services or procedures; 21)         Dental services not listed in Table D. b)         The dentist may request post-approval when a dental procedure requiring prior approval is provided on an emergency basis.  Approval of the procedures shall be given if the dental procedure is medically necessary. ## Nearby sections - [89 Ill. Adm. Code 1400.140.403 Section 140.403 Telehealth Services](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_403.md) - [89 Ill. Adm. 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Code 1400.140.414 Section 140.414 Requirements for Prescriptions and Dispensing of Pharmacy Items – Prescibers](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_414.md) - [89 Ill. Adm. Code 1400.140.416 Section 140.416 Optometric Services and Materials](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_416.md) - [89 Ill. Adm. Code 1400.140.417 Section 140.417 Limitations on Optometric Services](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_417.md) - [89 Ill. Adm. Code 1400.140.421 Section 140.421 Limitations on Dental Services](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_421.md) - [89 Ill. Adm. Code 1400.140.424 Section 140.424 Licensed Clinical Social Worker Services](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_424.md) - [89 Ill. Adm. Code 1400.140.434 Section 140.434 Record Requirements for Independent Clinical Laboratories](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_434.md) - [89 Ill. Adm. Code 1400.140.442 Section 140.442 Drug Product Prior Approval and the Preferred Drug List](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_442.md) - [89 Ill. Adm. Code 1400.140.443 Section 140.443 Filling of Prescriptions](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_443.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1400_S140_421. Check the current official text before relying on it. Not legal advice.