{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T01:09:20Z","timestamp":1785805760185,"version":"3.56.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Objective<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Examine state-level Medicaid reimbursement rates after Medicaid expansion for Phase I and II orthodontia relevant to patients with cleft lip and palate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Design<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Cross-sectional study of publicly available 2024 state Medicaid reimbursement rates associated with Phase I and II orthodontia. One-Way ANOVA and independent t-tests compared regional and Medicaid expansion groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Setting<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>National sample of Medicaid reimbursement fee schedules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Patients<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Fifty US states, including DC, utilizing fee-for-service reimbursement for Medicaid enrollees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Main Outcome Measure(s)<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Reimbursement Rates for CPT Code D8020 (Phase I: Limited Orthodontia, Transitional Dentition) and D8080 (Phase II: Comprehensive Orthodontia, Adolescent Dentition) were compared between regions and by Medicaid expansion status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Results<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>\n                      Ten states did not adopt Medicaid Expansion (19.6%: AL, FL, GA, KS, MS, SC, TN, TX, WI, and WY). Coverage of Phase I care was low overall (58.5% of expanded and 55.6% of non-expanded states), with average reimbursement of $1080.13. More states offered Phase II coverage (87.8% of expanded and 77.8% of non-expanded states). Phase II reimbursement was higher in expansion states ($2596.73\u2009\u00b1\u2009$2252.59 vs non-expansion: $1266.78\u2009\u00b1\u2009$314.19;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.001). The South trended toward higher reimbursement for Phase II ($3224.95;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.093), followed by the West ($2902.88\u2009\u00b1\u20091327.40 vs $1413.26-$1699.10).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Conclusions<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Provider reimbursement influences access to orthodontia. Although Medicaid expansion aims to improve access for low-income families, gaps in orthodontic coverage persist. Despite higher Phase II reimbursement in Southern and expansion states, inadequate Phase I coverage and low reimbursement schedules limit provider participation, leaving low-income patients with clefts at risk for delayed or absent orthodontia and thus suboptimal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261421052","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T18:03:26Z","timestamp":1771005806000},"page":"422-428","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Medicaid Expansion on State-Level Medicaid Reimbursement for Orthodontia in Patients With Cleft Lip and Palate: A Cost Analysis"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1607-7831","authenticated-orcid":false,"given":"Ronald Rae","family":"McCall","sequence":"first","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlie A","family":"Elver","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0235-7798","authenticated-orcid":false,"given":"Kendall C","family":"Pitre","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-2280","authenticated-orcid":false,"given":"Ian C","family":"Hoppe","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura S","family":"Humphries","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"e_1_3_2_2_2","volume-title":"StatPearls","author":"Phalke N","year":"2025","unstructured":"Phalke N, Goldman JJ. 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