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Lookup Codes: Insurance Payers Reimbursing Teledentistry Encounters

Coverage of Services Delivered through Telehealth Technology by Third Party Carriers

CODE CARRIER

D0140
limited oral evaluation – problem focused

Ameritas, Anthem, Argus Dental, Atena, Blue Cross Blue Shield Massachusetts, Blue Cross NC/ Dental Blue, CareFirst BlueCross BlueShield, Cigna, Delta Dental, DentaQuest, Dominion National, Envolve Dental, Guardian, Humana, Liberty, Lincoln Financial Group, MetLife, Principal, Sun Life, United Concordia, United Healthcare, Unum/Colonial Life

D0170
re-evaluation
– limited, problem focused

Ameritas, Anthem, Argus Dental, Atena, Blue Cross NC/ Dental Blue, CareFirst BlueCross BlueShield, Cigna, Delta Dental, DentaQuest, Dominion National, Envolve Dental, Guardia, Humana, Liberty, Lincoln Financial Group, MetLife, Principal, Sun Life, United Healthcare, Unum/Colonial Life

D0171
re-evaluation – post-operative office visit

Delta Dental, Dominion National, Envolve Dental, Guardian, Humana, Liberty, Lincoln Financial Group, United Healthcare

Based on ADA updates.

This is not an exhaustive list of teledentistry applicable codes.

Disclaimer: coverage subject to state laws, practice acts and individual policies. Check with carriers for further details. 

Note: When providing services via teledentistry, one of the following codes should also be reported: 

  • D9995 teledentistry – synchronous; real-time encounter
  • D9996 teledentistry – asynchronous; information stored and forwarded to dentist for subsequent review

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