October 2001: Dental Provisions #17
Summary of January 1, 2002, contract benefit variations:
Standard dental products for groups of 5 to 51 members
TMD services
As a rule, Regence BlueShield medical plans have not
covered non-surgical services for temporomandibular
disorders (TMD) when a dental provider performed the
services. However, our medical plans will begin covering
these services starting January 1, 2002, when the patient
lacks dental TMD coverage but has TMD medical coverage.
This change will help to fill in the void that existed
in coverage between medical and dental TMD plans. Please
call customer service for coverage verification.
Implants
Starting January 1, 2002, coverage for implants will
be a benefit available for purchase by employer groups.
If covered, implants will be paid at the same reimbursement
level as Class III, or prosthetic services (usually
50%). Implants will be covered when authorized in
advance by the company; this benefit will be included
in the overall annual maximum in force for the group
coverage. Please call customer service to verify
if your patient's contract covers implants.
Limited oral evaluation - problem focused
Limited oral evaluations - problem focused, D0140 (i.e.
emergency exams), will be covered at the Class II payment
amount, usually 80%, and will not accrue toward the
annual limitation of two examinations per year.
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