Medi-Cal Dental Manual of Criteria (MOC) and Schedule of Maximum Allowances (SMA)

Providers are required to follow all standards and guidelines set forth in the Manual of Criteria (MOC) and Medi-Cal Dental Schedule of Maximum Allowances (SMA).

The Medi-Cal Dental Program updates its Current Dental Terminology (CDT) code set regularly. Providers should refer to this page for the latest submission and criteria requirements.

Please note: Provider Handbook Section 5 contains the current MOC and SMA; the policies therein have been implemented under bulletin authority pending approvals from the state regulatory process. The most recent regulations-approved version is identified in the table at the beginning of Section 5, and is denoted with **.

Current MOC and SMA

Current California Advancing and Innovating Medi-Cal (CalAIM) Pay-for-Performance (P4P) Fee Schedules

Current Proposition 56 (Prop 56) Fee Schedule

Prop 56 Supplemental Dental Payments: Effective for dates of services on or after July 1, 2018*
(Published) | Tags: Prop 56 Supplemental Payments
*Effective March 1, 2023, select procedure codes eligible for Prop 56 supplemental payments were updated to reflect the new rate change codes D2330, D2331, and D2332. Refer to Provider Bulletin Volume 39, Number 03 for more information.

Past Draft MOCs and SMAs

CDT-22: New Rate Change for Codes D2330 (Resin-based composite – one surface, anterior), D2331 (Resin-based composite – two surfaces, anterior), and D2332 (Resin-based composite – three surfaces, anterior): Effective for dates of services on or after March 1, 2023 through March 31, 2023.
(Published) | Tags: MOC and SMA
Refer to Provider Bulletin Volume 39, Number 03 for more information.