Dental Quality Measures

DQA measures address prevention and disease management to promote oral health for both children and adults.

2026 Measure Specifications

Implementing the Latest Standards

Measures: Medicaid and Dental Plan Assessments

Please refer to the DQA User Guide before implementing these measures. All DQA measures undergo annual review. Please ensure you use the correct version for the measurement year.

Use “2026” version if you are using claims data from 2025. To access older versions of DQA measures specification or for questions related to the versions, please contact the DQA Staff at dqa@ada.org.


“Dental” vs. “Oral Health” Services

For the purpose of measurement, based on definitions from the Centers for Medicare & Medicaid Services: “Dental” services refer to services provided by or under the supervision of a dentist. “Oral health” services refer to services provided by other personnel e.g. pediatricians.

Refer to User Guides below for more detail.


User Guides

2026 DQA Adult Measures User Guide (PDF)

2026 DQA Pediatric Measures User Guide (PDF) 

Measures

Adult

Adults with Diabetes - Oral Evaluation

2026 Adults with Diabetes - Oral Evaluation  (PDF)

Ambulatory Care Sensitive Emergency Department Visits for Non-Traumatic Dental Conditions in Adults (CMIT #1784)

2026 Ambulatory Care Sensitive Emergency Department Visits for Non-Traumatic Dental Conditions in Adults (PDF)

Follow-Up after Emergency Department Visits for Non-Traumatic Dental Conditions in Adults

2026 Follow-Up after Emergency Department Visits for Non-Traumatic Dental Conditions in Adults (PDF)

Maintenance for Adults with Periodontitis

Practice Level Specifications

2026 Maintenance for Adults with Periodontitis (PDF)

Non-Surgical Ongoing Periodontal Care for People with Periodontitis

2026 Non-Surgical Ongoing Periodontal Care for People with Periodontitis (PDF)

Periodontal Evaluation in Adults with Periodontitis

2026 Periodontal Evaluation (PDF)

Topical Fluoride for Adults at Elevated Caries Risk

2026 Adult Topical Fluoride (PDF)

Pediatric

Ambulatory Care Sensitive Emergency Department Visits for Dental Caries in Children

2026 Ambulatory Care Sensitive Emergency Department Visits for Dental Caries in Children (PDF)

Care Continuity

Program and Plan Level Specifications

2026 Dental services: Care Continuity (PDF)

Practice Level Specifications

2026 Care Continuity for Children (PDF)

Caries Risk Documentation

2026 Caries Risk Documentation (PDF)

Early Childhood Oral Evaluation by a Dental Provider Following a Medical Preventive Service Visit

2026 Early Childhood Oral Evaluation by a Dental Provider Following a Medical Preventive Service Visit (PDF)

Follow-Up after Emergency Department Visits for Dental Caries in Children

2026 Follow-up after Emergency Department Visits for Dental Caries in Children (PDF)

Oral Evaluation (CMIT #897)

2026 Oral Evaluation (PDF)

Per Member Per Month Cost of Clinical Services

2026 Per Member Per Month Cost of Clinical Services (PDF)

Preventive Services for Children

2026 Preventive Services for Children (PDF)

Receipt of Sealants on First Permanent Molar (CMIT #830)

Program and Plan Level Specifications

2026 Sealants Receipt on Permanent First Molar (PDF)

Practice Level Specifications

2026 Sealant Receipt on Permanent First Molar (PDF)

Receipt of Sealants on Second Permanent Molar

2026 Sealant Receipt on Permanent Second Molar (PDF)

Topical Fluoride for Children (CMIT #1672)

Program and Plan Level Specifications

2026 Topical Fluoride for Children (PDF)

Practice Level Specifications

2026 Topical Fluoride for Children (PDF)

Treatment Services

2026 Treatment Services (PDF)

Usual Sources of Care

2026 Usual Source of Services, Dental Services (PDF)

Utilization of Services

2026 Dental services: Utilization of Services (PDF)

2026 Oral Health Services: Utilization of Services (PDF)

2026 Dental or Oral Health Services: Utilization of Services (PDF)

Pregnancy

Oral Evaluation During Pregnancy (CMIT #1783)

2026 Oral Evaluation During Pregnancy (PDF)

Utilization of Services During Pregnancy

2026 Utilization of Services During Pregnancy (PDF)