Teledentistry Reminder for Providers
As previously communicated, Horizon NJ Health expanded coverage to include consultation through teledentistry. This was in response to dental office closings due to the COVID-19 public health emergency. This expanded coverage provided reimbursement to dentists when intervening in emergent and urgent conditions for new and established patients, and helped to keep members out of Emergency Rooms while dental offices were closed.
The following codes should be used for teledentistry services for emergent or urgent dental care initiated by the member, their parent or representative:
- D0191 – Assessment of a patient; use for the initial phone call. This is allowed once per date of service.
- D9995 – Teledentistry – Synchronous; real-time encounter; use in conjunction with D0191 for the use of audio-visual platforms.
Patient-initiated interactions must be documented in the records and include the rationale for the service.
These teledentistry encounters may continue with appropriate documentation of medical necessity throughout the COVID-19 public health emergency only for patients who remain unable or unwilling to visit the dental office due to the ongoing public health emergency.
Patients should now have access to onsite dental treatment and should be scheduled for an appointment based on their condition (within 48 hours or earlier if condition warrants) or urgent condition (within 72 hours).