Medicaid and CHIP Dental Coverage for Children

What federal rules require for children's dental care under Medicaid (EPSDT) and CHIP, how to use InsureKidsNow, and what to ask a dental office first.

Children covered by Medicaid or the Children's Health Insurance Program (CHIP) have dental benefits. The details vary by state, but federal rules set a floor. This guide explains those rules in plain terms, shows you the official dentist finder for Medicaid and CHIP, and gives you questions to ask a dental office before you book.

Medicaid: dental care through EPSDT

For children, Medicaid covers dental care through a benefit called Early and Periodic Screening, Diagnostic and Treatment, or EPSDT. According to Medicaid.gov, EPSDT applies to Medicaid enrollees under age 21. States must tell eligible families that EPSDT services are available and arrange for screenings and follow-up treatment. EPSDT also requires coverage of services that federal Medicaid law allows when they are medically necessary to treat or correct a condition found during screening.

Medicaid.gov's page on dental care sets out the dental side. At a minimum, covered dental services for children must include:

• Relief of pain and infections.
• Restoration of teeth.
• Maintenance of dental health.

The same page says each state must develop a dental periodicity schedule, which is the timetable for checkups and preventive care, in consultation with dental organizations. It also says a referral to a dentist is required for every child. The AAPD tracks which schedule each state uses for its Medicaid program.

CHIP: dental coverage is required too

CHIP covers children in families whose income is too high for Medicaid but too low to afford private coverage. When a state runs CHIP as an expansion of Medicaid, children get the same benefits as the state's Medicaid plan. For separate CHIP programs, Medicaid.gov's page on CHIP benefits says dental coverage must include services needed to:

• Prevent disease and promote oral health.
• Restore oral structures to health and function.
• Treat emergency conditions.

States can design their own CHIP dental package or choose a benchmark package. A benchmark package must be substantially equal to one of three options: the the most popular federal employee dental plan for dependents, the most popular dependent option in the state employee dental plan, or dental coverage from the most popular commercial insurer in the state. That is why CHIP dental benefits can look different from one state to the next.

Finding a dentist who takes your child's plan

States must post their benefit packages and participating Medicaid and CHIP dentists on InsureKidsNow.gov, a federal site. Its Find a Dentist tool works like this:

1. Choose the state where your child has coverage.
2. Choose your child's benefit plan from the list for that state. The plan name is usually on your child's card.
3. Enter an address or ZIP code and pick a search radius.
4. If you like, filter by dentists taking new patients, dentists who serve children with special health care needs, languages spoken, or specialty, including pediatric dentistry.

InsureKidsNow notes that families should call to confirm a dentist is taking new patients under the selected plan. It also notes that some dentists need a referral from another dentist first, that many dentists will see a new patient for a one-time emergency visit, and that free interpreter services are available if you cannot find a dentist who speaks your language.

Questions to ask the dental office

Networks change, and a practice may take one Medicaid or CHIP plan but not another. Have your child's card in hand when you call, and ask:

• "Do you accept [plan name exactly as it appears on the card] for new patients?"
• "Does every dentist in the office take this plan, or only some of them? Which location?"
• "Do you see children my child's age?" Some offices start at a certain age.
• "Do you need a referral before the first visit?"
• "If my child needs treatment that the plan must approve first, who sends the request?"
• "If my child needs sedation or care in a hospital, where would you refer us, and does that place take this plan?"
• "Will I be asked to pay anything at the visit?"
• "How soon can you see a new patient? What do you do for urgent problems?"

Write down the date, the name of the person you spoke with and what they said. If an office says it no longer takes your plan, ask whether it can suggest another office that does.

If you cannot find a dentist

Call the member services number on your child's card. The plan can tell you which dentists are in its network near you. You can also contact your state Medicaid agency. Medicaid.gov keeps a state-by-state contact list for applying, renewing and finding providers. To ask about coverage for your child, InsureKidsNow lists a national phone number, 1-877-KIDS-NOW (1-877-543-7669), and explains how to apply in your state. If your child has a dental emergency with heavy bleeding, a serious face injury or trouble breathing, call 911.

How this site fits in

Every listing on this site comes from the federal NPPES registry, where dentists and practices apply for a National Provider Identifier (NPI). On that application the provider picks a taxonomy code that describes its type and specialty, and marks one code as primary, as CMS explains on its taxonomy page. Listings here use the Pediatric Dentistry code, 1223P0221X. That means the dentist or practice chose that code. It is not a license check and it is not board certification, and this site does not verify it.

The site does not show which plans a practice accepts. Use InsureKidsNow or your plan's directory for that, then call to confirm. What you can use this site for is checking the facts behind an office you found: the license number and state as entered, years since the NPI was issued, other practice locations, and how many pediatric dentistry listings share an address. Compare puts up to three side by side. Our guide to pediatric dentists and family dentists shows how to check a license and board certification, and our guide to your child's first dental visit covers what happens at early checkups. Search the directory to start.

Updated 2026-10-16.

General information only, current as of the date above. The information on Pediatric Dentist Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Rules and programs change; check the official sources linked in this guide.