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Cleft Palate Diagnoses

Provider Type

  • Physicians
  • Hospitals
  • Participating Physician Groups (PPG)

Health Net covers medically necessary dental or orthodontic services that are an integral part of cleft palate reconstruction. Cleft palate may also include, cleft lip or other craniofacial anomalies associated with cleft palate.

To the extent that Medi-Cal members who require medically necessary dental or orthodontic services are determined eligible for the California Children's Services (CCS) program, these services are provided by CCS.

Prior authorization for cleft palate reconstruction, including dental and orthodontic services, is required for all HMO, EPO, Point of Service (POS), and PPO products.

Last Updated: 07/01/2024