About the Early and Periodic Screening, Diagnosis, and Treatment (CMS-416) Report Data

This page provides information about dental and oral health service use among Minnesota Health Care Programs (MHCP) children enrollees eligible for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)/Child and Teen Checkups (C&TC).


Which pages include the data?


What do the data tell us?

  • The number and percent of MHCP children enrollees who received the following dental services (by year, age group and county of residence):
    • any dental service,
    • preventive dental service,
    • dental treatment service,
    • dental sealant service,
    • dental diagnostic service,
    • oral health service by a non-dentist, and
    • any dental or oral health service
  • If dental service use among MHCP children enrollees is going up or down over time
  • If dental service use among MHCP children enrollees is higher or lower among certain age groups, racial/ethnic groups, or counties

Why are the data important?

  • MHCP enrollees represent low-income children who may experience higher and more severe rates of dental disease and reduced access to dental services.

How can we use the data?

  • Inform educators, oral health, medical and public health professionals, researchers, grant makers, policy makers, and the public
  • Focus resources and program activities towards MHCP enrollees, age groups, or counties with low dental service use
  • State and local program planning and evaluation

What will the data not tell us?

  • Dental service use among low-income children not eligible to participate or not enrolled in a MHCP
  • More specific types of dental services (e.g., dental cleaning, root canal, etc…)

What are the oral health measures/indicators in the data?

  • Any dental service: The total number or percentage of eligible children receiving any dental service. A dental service is any diagnostic, preventive, or corrective procedure provided by or under the supervision of a dentist. Line 12a of the EPSDT/C&TC (CMS-416) Report.
  • Preventive dental service: The total number or percentage of eligible children receiving a preventive dental service. Examples of preventive dental services include dental cleanings and fluoride application. Line 12b of the EPSDT/C&TC (CMS-416) Report.
  • Dental treatment service: The total number or percentage of eligible children receiving a dental treatment service. Dental treatment services include corrective procedures such as a dental cavity filling. Line 12c of the EPSDT/C&TC (CMS-416) Report.
  • Dental sealant service: The total number or percentage of eligible children receiving at least one dental sealant on a permanent molar tooth. Line 12d of the EPSDT/C&TC (CMS-416) Report.
  • Dental diagnostic service: The total number or percentage of eligible children receiving a dental diagnostic service. Dental diagnostic services include procedures such as x-rays and clinical exams. Line 12 e of the EPSDT/C&TC (CMS-416) Report.
  • Non-dentist oral health service: The total number or percentage of eligible children receiving an oral health service by a non-dentist such as a primary care doctor or dental health professionals not under the supervision of a dentist. Line 12f of the EPSDT/C&TC (CMS-416) Report.
  • Any dental or oral health service: The total number or percentage of eligible children receiving any dental or oral health service. A dental or oral health service is any service provided by or under the supervision of a dentist (dental service) or any service provided by non-dentists such as a primary care doctor or a dental health professional not under the supervision of a dentist (oral health service). Line 12g of the EPSDT/C&TC (CMS-416) Report.

How are the measures/indicators calculated?

The number of dental or oral health service claims (Lines 12a to 12g) divided by the total number of Children Medicaid/Minnesota Health Care Programs enrollees, multiplied by 100-percent.

Total enrollees: The total number of children under the age of 21 enrolled in a Minnesota Health Care Program for at least 90-consecutive days in the federal fiscal year and determined to be eligible for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)/Child and Teen Checkup (C&TC) services. Line 1b of the EPSDT/C&TC (CMS-416) Report.


What are the limitations of the data?

  • Unduplicated counts within dental/oral health service categories: Medicaid/Minnesota Health Care Programs children enrollees are counted only once within each oral health service category (Lines 12a to 12g).
  • Duplicated counts across dental/oral health categories: An individual enrollee may be counted in two or more categories (Lines 12a to 12g). For example, individuals under the age of 21 may be counted once on Line 12a for receiving any dental service, counted again on Line 12c for receiving a dental treatment service and, if applicable, counted again on Line 12f for receiving an oral health service by a qualified health care practitioner or by a dental professional who is neither a dentist nor providing services under the supervision of a dentist.
  • Claim/encounter data are limited to the final version of paid claims where the service date is in each respective federal fiscal year (October 1 through September 30).
  • An eligible individual in the dataset means the individual is enrolled in a MHCP for at least 90-continuous days. A child may be enrolled in more than one major program during a month and during the federal fiscal year.
  • MHCP enrollee age is calculated as the end of the federal fiscal year, September 30. Enrollees without a recorded birthdate are excluded.
  • Race/ethnicity was combined using the "Hispanic trump race" method. All the race categories are Non-Hispanic versions of each race and the Hispanic individuals are assigned to a category of "Hispanic/Latino of any race." Pacific Islanders were combined into the Asian category.
  • Data includes paid dental claims (fee-for service and managed care).
  • County of residence: The county recorded in the dataset is the county of financial responsibility or the MHCP enrollee's county of residence in the current federal fiscal year. Individuals not in a valid Minnesota county were removed.
  • Dental services recipients: A child is counted as a dental service recipient in each federal fiscal year if at least one dental related fee-for-service or managed care encounter claim was submitted with a service date during the federal fiscal year. A recipient is counted only once in each federal fiscal year regardless of how many services were provided.
  • Dental claims by tribe are not representative of all the eleven tribes in Minnesota.

What are the limitations of the data?

Minnesota Department of Human Services (DHS). The Department of Human Services Data Warehouse stores information produced by the Medicaid Management Information System (MMMIS) to track fee-for-service claims activity and encounter data from managed care health plans. This data is reported in the Early and Periodic Screening, Diagnosis, and Treatment (CMS-416) Report.


Why are there only four tribes listed in the dataset?

Minnesota has eleven federally recognized tribes. Four of the 11 federally recognized tribes hold contracts with the Department of Human Services for EPSDT outreach activities and are therefore included in the dataset.


How should I cite the data and information?

Minnesota Department of Human Services. Early and Periodic Screening, Diagnosis, and Treatment (CMS-416) Report. Collected by the Minnesota Oral Health Statistics System, Minnesota Department of Health, Oral Health Program, August 2015.


Where can I find more technical information about the data?

Please send questions or comments to: Minnesota Department of Health, Oral Health Program.