The two major private dental insurers in Massachusetts, Delta Dental and Blue Cross Blue Shield, have issued updated policies to allow for certain dental services to be covered if done virtually by teledentistry.
Delta Dental has issued an interim policy change lasting for 30 days from March 20, 2020 allowing offices to submit claims for evaluations done via audio or video technology using an “Oral Evaluation-Problem Focused code (D0140). These claims will be paid for patients with Delta Dental coverage.
Blue Cross Blue Shield has announced that effective March 23, 2020 and until further notice it will cover “virtual consultations” done via telephone or video submitted through the D0140 code with no share (deductible, copayment or co-insurance). The patients’ charts should contain certain details of the consultation,, which must be patient-initiated and related to a specific dental problem that otherwise would be necessarily treated with an in-office visit.
MassHealth also has announced that it will cover certain teledentistry services, as detailed in MassHealth All Provider Bulletin 289. The test for deciding whether a teledentistry procedure can be billed through MassHealth is if it was a covered procedure previously through MassHealth, if it is clinically appropriate to be delivered via telehealth, and if it is medically necessary. All other MassHealth guidelines and directives in Bulletin 289 apply. The rates that are previously paid for these services also apply to services performed by teledentistry. Since teledentistry is a very new phenomenon (and highly controversial in some respects) it is likely that more guidance will follow from both insurers and dental boards regarding its use during the Covid-19 crisis.
By Brian Hatch, Esq
Hatch Legal Group,
8 North Main Street,
Attleboro, MA 02703
brianhatch@hatchlawoffices.com
