Or. Admin. R. 410-123-1510 – Additional Dental Benefits for Pregnant and Postpartum Members

(1) This rule sets forth the access standards for dental care for members who are pregnant or 12 months postpartum.
(2) Pregnant members must be seen, treated in person or via teledentistry for the following OHP-covered service and within the following time frames:
1. (a) Emergency dental care: within 24 hours;
2. (b) Urgent dental care: within one (1) week.
3. (c) Routine dental care: within four (4) weeks, unless there is a documented special clinical reason that may make it appropriate to be seen or treated beyond this time frame;
4. (d) Initial dental screening or examination: within four (4) weeks.
(3) The following additional dental services are available to pregnant members if authorized as medically or dentally necessary due to the pregnancy:
1. (a) Prophylaxis, fluoride, and periodontal services;
2. (b) Permanent crowns and resin-based composite crowns for anterior teeth;
3. (c) Prefabricated post and core;
4. (d) Root canals on first molars;
5. (e) Apexification/recalcification, pulpal regeneration; and
6. (f) Alveoloplasty not in conjunction with extractions.
(4) Nothing in this rule obligates a pregnant member to accept an offered service.

ORS 413.042 & ORS 414.065

ORS 414.065