As an emergency response to office closures due to the COVID-19 public health emergency, Horizon NJ Health enacted several measures to help health care professionals treat their patients, including teledentistry options. Horizon NJ Health will reimburse for assessment (D0191) via a telephone encounter or when needed in conjunction with the use of synchronous teledentistry (D9995). This allows the use of audio–visual platforms for emergent or urgent dental care initiated by the member, their parent or representative. These encounters can be for a new or an established patient.
We implemented these codes to enable a dentist to intervene in emergent and urgent conditions, and to potentially reduce the need for patients to go to the Emergency Room while dental offices were closed.
When your office reopens, patients can access on-site dental treatment and should be scheduled for an appointment based on an emergent condition (within 48 hours or earlier if condition warrants) or an urgent condition (within 72 hours). When patients are able to access your office, the assessment and teledentistry codes should no longer be billed.
As we continue to monitor the changes in the dental and health care system, you have our commitment to keep you informed.