{"id":2657,"date":"2021-09-21T12:32:43","date_gmt":"2021-09-21T12:32:43","guid":{"rendered":"https:\/\/mconsent.net\/?p=2657"},"modified":"2024-04-15T11:10:34","modified_gmt":"2024-04-15T11:10:34","slug":"teledentistry-and-insurance-coverage-coding","status":"publish","type":"post","link":"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/","title":{"rendered":"Teledentistry and Insurance Coverage\/Coding?"},"content":{"rendered":"\r\n<p>\u201cDoes my insurance cover it?\u201d Understandably, this is the first question every patient asks regarding <a href=\"https:\/\/mconsent.net\/blog\/teledentistry-improve-dental-office-revenue\/\" target=\"_blank\" rel=\"noopener\">teledentistry<\/a>. The answer heavily depends on several factors, which we\u2019ll break down in this article.\u00a0<\/p>\r\n\r\n\r\n\r\n<p>Although teledentistry has been around for over 2 decades, it recently gained spotlight attention during the COVID pandemic. Dentists and patients alike were desperately seeking safer, alternative ways to have consultations, emergency triage, and post-op visits remotely.<\/p>\r\n\r\n\r\n\r\n<p>Teledentistry was initially designed to \u201cimprove <a href=\"https:\/\/mconsent.net\/blog\/future-transforming-patient-care-paperless-medical-history-forms\/\" target=\"_blank\" rel=\"noopener\">patient care<\/a>, increase dental education, and promote communication between dentists and labs.\u201d<sup>1<\/sup> From the initial establishment until the present time, a myriad of benefits have come from teledentistry, including convenience, safety of care, lower costs for patients, ability to serve those in hard-to-reach remote areas, and a decrease in dental-related emergency visits.\u00a0<\/p>\r\n\r\n\r\n\r\n<p>Services that patients are able to receive from teledentistry have also expanded to include the following:<\/p>\r\n\r\n\r\n\r\n<ul>\r\n<li>Triage Emergency Visits<\/li>\r\n<li>Pre-exam and Post-op visits<\/li>\r\n<li><a href=\"https:\/\/mconsent.net\/blog\/2-way-texting\/\" target=\"_blank\" rel=\"noreferrer noopener\">2-Way Texting<\/a> and Audiovisual Communication<\/li>\r\n<li>Discussion of Diagnosis and Treatment Plans<\/li>\r\n<li>Live Group Interactions with Staff &amp; Specialists<\/li>\r\n<li>Transfer of Educational Resources and Information<\/li>\r\n<li>Asynchronous Transmission of Health Records Including Images\u00a0<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>The list of uses for teledentistry continues to grow as the number of patients and dentists utilizing it drastically increases. One thing that\u2019s for sure, is that teledentistry is here to stay long-term.<\/p>\r\n\r\n\r\n\r\n<h2 class=\"wp-block-heading\" style=\"font-size: 30px; border-left: 5px solid #38b0c2; padding-left: 10px; font-weight: 600;\"><strong>Does Insurance Cover It?<\/strong><\/h2>\r\n\r\n\r\n\r\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"536\" class=\"wp-image-2669\" src=\"https:\/\/mconsent.net\/wp-content\/uploads\/2021\/09\/insurance-1024x536.jpg\" alt=\"\" srcset=\"https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/insurance-1024x536.jpg 1024w, https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/insurance-300x157.jpg 300w, https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/insurance-768x402.jpg 768w, https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/insurance.jpg 1200w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\r\n\r\n\r\n\r\n<p>The exploding demand for teledentistry has led patients and dentists flocking to insurance companies seeking information about coverage status for telehealth services.Pri mary factors affecting <a href=\"https:\/\/mconsent.net\/insurance-verification\/\" target=\"_blank\" rel=\"noopener\">insurance coverage<\/a> include: location, insurance provider, and policy.<\/p>\r\n\r\n\r\n\r\n<h2 class=\"wp-block-heading\" style=\"font-size: 30px; border-left: 5px solid #38b0c2; padding-left: 10px; font-weight: 600;\"><strong>Location &amp; Insurance<\/strong><\/h2>\r\n\r\n\r\n\r\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/mconsent.net\/insurance-verification\/\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"536\" class=\"wp-image-2716\" src=\"https:\/\/mconsent.net\/wp-content\/uploads\/2021\/09\/health-imsurance-blog-1024x536.jpg\" alt=\"\" srcset=\"https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/health-imsurance-blog-1024x536.jpg 1024w, https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/health-imsurance-blog-300x157.jpg 300w, https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/health-imsurance-blog-768x402.jpg 768w, https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/health-imsurance-blog.jpg 1200w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/a><\/figure>\r\n\r\n\r\n\r\n<p>Because the scope of teledentistry and telehealth services varies, state dental boards, policy makers, and insurance providers differ in which services are permitted or covered, along with a host of particular regulations. Dentists have also witnessed changes in those legislations over the course of the COVID pandemic.\u00a0<\/p>\r\n\r\n\r\n\r\n<p>Some states have established extensive teledentistry laws, whereas with others, they are nonexistent. On top of that, private payers vs state medicaid programs also reimburse differently depending on the state. The discussion on reimbursement for telehealth can get quite complex quickly.<\/p>\r\n\r\n\r\n\r\n<p>Lawmakers go to a great extent in defining elements of reimbursement including, but not limited to matters like payment parity laws. This law requires insurers to pay for <a href=\"https:\/\/mconsent.net\/blog\/hipaa-telehealth-dental-services\/\" target=\"_blank\" rel=\"noopener\">telehealth<\/a> at the same rate as in-person services, and exists in some states, but not others. As you can imagine, lawmakers and insurers have presented arguments from both sides, for and against payment parity laws such as:<\/p>\r\n\r\n\r\n\r\n<ul>\r\n<li>The amount of effort expended towards telehealth vs in-person services<\/li>\r\n<li>The value of care provided via telehealth vs in-person care<\/li>\r\n<li>Expenses from the practitioner&#8217;s end in telehealth vs in-person visits<\/li>\r\n<li>The potential for telehealth overuse<\/li>\r\n<li>And so forth\u2026<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>In-depth articles have been written solely about telehealth payment parity, in addition to numerous other factors taken into consideration when determining insurance reimbursement for telehealth services.<\/p>\r\n\r\n\r\n\r\n<h2 class=\"wp-block-heading\" style=\"font-size: 30px; border-left: 5px solid #38b0c2; padding-left: 10px; font-weight: 600;\"><strong>How Should You Code for Teledentistry?<\/strong><\/h2>\r\n\r\n\r\n\r\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"536\" class=\"wp-image-2672\" src=\"https:\/\/mconsent.net\/wp-content\/uploads\/2021\/09\/blog-insurance-1024x536.jpg\" alt=\"\" srcset=\"https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/blog-insurance-1024x536.jpg 1024w, https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/blog-insurance-300x157.jpg 300w, https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/blog-insurance-768x402.jpg 768w, https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/blog-insurance.jpg 1200w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\r\n\r\n\r\n\r\n<p>Knowing proper coding for teledentistry will save endless headaches of reimbursement delays and denials. The first step is ensuring that the actual provider of the service(s) is submitting the CDT codes. Secondly, include the relevant codes for services provided in addition to the full teledentistry CDT code.<\/p>\r\n\r\n\r\n\r\n<h2 class=\"wp-block-heading\">The two full CDT codes are:<\/h2>\r\n\r\n\r\n\r\n<ul>\r\n<li><strong>D9995 teledentistry:<\/strong> synchronous; real-time encounter.\u00a0<\/li>\r\n<li><strong>D9996 teledentistry:<\/strong> asynchronous; information stored and forwarded to the dentist for subsequent review.\u00a0<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>(The two full CDT codes should be reported in addition to other procedural codes (e.g. diagnostic) delivered to the patient on the date of service.) <sup>2\u00a0<\/sup><\/p>\r\n\r\n\r\n\r\n<ul>\r\n<li>D0140 \u2013 limited oral evaluation \u2013 problem focused\u00a0<\/li>\r\n<li>D0170 \u2013 re-evaluation \u2013 limited, problem focused (established patient)\u00a0<\/li>\r\n<li>D0171 \u2013 re-evaluation post \u2013 operative office visit<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p><strong>Example<\/strong>: D0140 on line item 1, D9995 on line item 2<\/p>\r\n\r\n\r\n\r\n<p><strong><a href=\"https:\/\/www.ada.org\/~\/media\/ADA\/Publications\/Files\/CDT_D9995D9996-GuideTo_v1_2017Jul17.pdf\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Here\u2019s a free resource<\/a><\/strong> to better help you understand teledentistry coding.<\/p>\r\n\r\n\r\n\r\n<h2 class=\"wp-block-heading\" style=\"font-size: 30px; border-left: 5px solid #38b0c2; padding-left: 10px; font-weight: 600;\"><strong>Where do Dental Insurance Providers Stand on Telehealth Coverage?<\/strong><\/h2>\r\n\r\n\r\n\r\n<h3><strong>Medicare*<\/strong><\/h3>\r\n<p>&#8211; Current Federal laws and policies<br \/>Live Video: Yes<br \/>Store-and-Forward: yes<br \/>Remote Patient monitoring: Yes, with with limitations<sup>3<\/sup><br \/>Details can be found <a href=\"https:\/\/www.cchpca.org\/federal\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\"><strong>here<\/strong><\/a>.<\/p>\r\n\r\n\r\n\r\n<h3><strong>Aetna*<\/strong><\/h3>\r\n<p><br \/>Live Video and Store-and-Forward Telemedicine with limitations<sup>4<\/sup><br \/>Further details can be found <a href=\"https:\/\/www.aetna.com\/health-care-professionals\/covid-faq\/telemedicine.html\" target=\"_blank\" rel=\"noreferrer noopener nofollow\"><strong>here<\/strong><\/a>.<\/p>\r\n\r\n\r\n\r\n<h3><strong>Blue Cross Blue Shield*<\/strong><\/h3>\r\n<p><br \/>Details about teledentistry services can be found <strong><a href=\"https:\/\/www.bcbstx.com\/insurance-basics\/coverage-information\/teledentistry\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">here<\/a><\/strong>.<\/p>\r\n\r\n\r\n\r\n<h3><strong>Delta Dental*<\/strong><\/h3>\r\n<p><br \/>Teledentistry services are dependent upon plans<sup>5<\/sup><br \/>Further details can be found <strong><a href=\"https:\/\/www.deltadentalri.com\/Content\/Docs\/Delta_TeledentistryBenefit_2020.pdf\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">here<\/a><\/strong>.<\/p>\r\n\r\n\r\n\r\n<h3><strong>United Healthcare Dental*<\/strong><\/h3>\r\n<p><br \/>Details about services eligible for teledentistry can be found <strong><a href=\"https:\/\/newsroom.uhc.com\/news-releases\/unitedhealthcare-teledentistry.html\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">here<\/a><\/strong>.<\/p>\r\n\r\n\r\n\r\n<h3><strong>Humana Dental*<\/strong><\/h3>\r\n<p><br \/>Details about teledentistry services can be found <strong><a href=\"https:\/\/www.humana.com\/provider\/coronavirus\/telemedicine\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">here<\/a><\/strong>.<\/p>\r\n\r\n\r\n\r\n<p>*Note that teledentistry\/telehealth coverage policies are continuously changing. Current coverage status must be verified with the Insurance Provider.<\/p>\r\n\r\n\r\n\r\n<p>To learn about teledentistry regulations in your state <strong><a href=\"https:\/\/www.cchpca.org\/covid-19-actions\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">click here<\/a><\/strong><\/p>\r\n\r\n\r\n\r\n<h3 class=\"wp-block-heading\" style=\"font-size: 30px; border-left: 5px solid #38b0c2; padding-left: 10px; font-weight: 600;\"><strong>Moving Forward<\/strong><\/h3>\r\n\r\n\r\n\r\n<p>The future of state regulations and insurance coverage for teledentistry, will continue to be a hot topic across the board. More research and understanding of the benefits vs drawbacks of teledentistry are still in progress and require thorough evaluation before sound policies are established. Learn how mConsent can set your practice up with convenient teledentistry services.<\/p>\r\n\r\n\r\n\r\n<h3 class=\"wp-block-heading\">References:<\/h3>\r\n\r\n\r\n\r\n<p style=\"font-size: 17px;\"><a href=\"https:\/\/virtudent.com\/2019\/12\/10\/what-is-teledentistry-anyway\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\"><em><sup>1<\/sup><\/em> <\/a>https:\/\/virtudent.com\/2019\/12\/10\/what-is-teledentistry-anyway\/<br \/><em><sup><a href=\"https:\/\/www.ada.org\/~\/media\/ADA\/Publications\/Files\/CDT_D9995D9996-GuideTo_v1_2017Jul17.pdf\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">2<\/a><\/sup><\/em> https:\/\/www.ada.org\/~\/media\/ADA\/Publications\/Files\/CDT_D9995D9996-GuideTo_v1_2017Jul17.pdf<br \/><em><sup><a href=\"https:\/\/www.cchpca.org\/federal\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">3<\/a><\/sup><\/em> https:\/\/www.cchpca.org\/federal\/<br \/><em><sup><a href=\"https:\/\/www.aetna.com\/health-care-professionals\/covid-faq\/telemedicine.html\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">4<\/a><\/sup><\/em> https:\/\/www.aetna.com\/health-care-professionals\/covid-faq\/telemedicine.html<br \/><em><sup><a href=\"https:\/\/www.deltadentalri.com\/Content\/Docs\/Delta_TeledentistryBenefit_2020.pdf\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">5<\/a><\/sup><\/em> https:\/\/www.deltadentalri.com\/Content\/Docs\/Delta_TeledentistryBenefit_2020.pdf<\/p>\r\n","protected":false},"excerpt":{"rendered":"<p>\u201cDoes my insurance cover it?\u201d Understandably, this is the first question every patient asks regarding teledentistry. The answer heavily depends on several factors, which we\u2019ll break down in this article.\u00a0 Although teledentistry has been around for over 2 decades, it recently gained spotlight attention during the COVID pandemic. Dentists and patients alike were desperately seeking [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":2718,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4226,10,5668,5669,4625,3116,4407,7027,4506,46,6894,6706],"tags":[2909,2902,2900,2910,15,2904,2901,2903,2908,2907],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v22.5 (Yoast SEO v22.6) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>All about Teledentistry and Insurance Coverage or Coding | mConsent<\/title>\n<meta name=\"description\" content=\"Know how mConsent can set your practice up with convenient teledentistry services and how can you code for Teledentistry. Visit us online to know more details about it.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Teledentistry and Insurance Coverage\/Coding?\" \/>\n<meta property=\"og:description\" content=\"\u201cDoes my insurance cover it?\u201d Understandably, this is the first question every patient asks regarding teledentistry. The answer heavily depends on several\" \/>\n<meta property=\"og:url\" content=\"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/\" \/>\n<meta property=\"og:site_name\" content=\"mConsent\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/mConsent\/\" \/>\n<meta property=\"article:published_time\" content=\"2021-09-21T12:32:43+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-04-15T11:10:34+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/Teledentistry-and-Insurance-Coverage-Coding.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"628\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@admin\" \/>\n<meta name=\"twitter:site\" content=\"@srsweb\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\/\/mconsent.net\/blog\/#\/schema\/person\/ec7847784e317e14f0f1831b19e9cedc\"},\"headline\":\"Teledentistry and Insurance Coverage\/Coding?\",\"datePublished\":\"2021-09-21T12:32:43+00:00\",\"dateModified\":\"2024-04-15T11:10:34+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/\"},\"wordCount\":843,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/mconsent.net\/blog\/#organization\"},\"image\":{\"@id\":\"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/Teledentistry-and-Insurance-Coverage-Coding.jpg\",\"keywords\":[\"dental care insurance\",\"dental insurance\",\"dental teledentistry\",\"insurance coverage for telehealth\",\"Teledentistry\",\"teledentistry solutions\",\"telehealth dentistry\",\"telehealth insurance coverage\",\"telehealth services\",\"telehealth usa\"],\"articleSection\":[\"Dental Insurance\",\"Dental Offices\",\"Digital Front Door\",\"Digitized World\",\"Healthcare Office\",\"Hipaa\",\"Insurance Verification Software\",\"Medical Consent Forms\",\"Online Patient Intake Forms\",\"Optometry Office\",\"Paperless Dental Software\",\"Patient Engagement &amp; Retention\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/\",\"url\":\"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/\",\"name\":\"All about Teledentistry and Insurance Coverage or Coding | mConsent\",\"isPartOf\":{\"@id\":\"https:\/\/mconsent.net\/blog\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/mconsent.net\/blog\/teledentistry-and-insurance-coverage-coding\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/mconsent.net\/blog\/wp-content\/uploads\/2021\/09\/Teledentistry-and-Insurance-Coverage-Coding.jpg\",\"datePublished\":\"2021-09-21T12:32:43+00:00\",\"dateModified\":\"2024-04-15T11:10:34+00:00\",\"description\":\"Know how mConsent can set your practice up with convenient teledentistry services and how can you code for Teledentistry. 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