Medicaid orthodontic HLD index worksheet
Each state Medicaid program scores orthodontic medical necessity on its own Handicapping Labio-Lingual Deviations (HLD) form. Pick your state, enter the measurements, and get the item points, the total against that form's threshold and whether an automatic qualifying condition is marked, plus a narrative to paste and a printable worksheet. The plan makes the decision; the worksheet reports the arithmetic.
States
- FloridaLIBERTY Dental Plan (Florida SMMC) form, FL-Medicaid-HLD_2019.09.23. Verified data through 2027-03-28.
- Request your stateTell us the state and the Medicaid dental plan; a state is added once its form is verified from the published source.
A state appears here only after its form has been transcribed from the plan's published PDF, pinned by digest, and checked twice. Each state's data has a verification window; once it lapses the state shows as not yet supported until it is re-verified.