Texas Medicaid continues to restrict dentists from using some of the most widely accepted crown materials when treating patients’ permanent molars. This outdated policy must change.
Following consultation with dental professionals, TDMR urges the Texas Health and Human Services Commission (HHSC) to extend reimbursement eligibility for two existing dental procedure codes, D2740 and D2751, to permanent molars.
According to 2024 statistics attributed to Glidewell, one of the nation’s largest dental laboratories, zirconia accounts for 86.7% of posterior crown restorations, E.max for 6.1%, and porcelain-fused-to-metal crowns for 5.4%.
Together, these materials represent an estimated 98.2% of posterior crown restorations in the reported figures.
Yet Texas Medicaid restricts reimbursement for D2740, covering porcelain and ceramic crowns, and D2751, covering porcelain fused to predominantly base metal, to anterior teeth and premolars.
Permanent molars are excluded.
Why does Texas Medicaid deny reimbursement for materials that have become overwhelmingly popular in modern restorative dentistry?
Molars withstand substantial chewing forces, so choosing durable restorative materials matters. Dentists should be able to choose the most appropriate crown based on clinical necessity and the individual patient’s needs.
Instead, Medicaid reimbursement rules limit that professional judgment.
HHSC needs to change this policy
Texas Medicaid’s policies should reflect contemporary dental practice rather than unnecessarily restrict treatment options.
If zirconia, E.max, and porcelain-fused-to-metal crowns account for an estimated 98.2% of posterior restorations, HHSC should be able to explain the clinical justification for excluding these materials from reimbursement for permanent molars.
If no compelling clinical justification exists, the restrictions should be removed.
Texas Medicaid patients deserve access to modern restorative dentistry, and their dentists deserve the professional flexibility to provide it.