Delta Dental of California announced it will temporarily offer its network providers a $10 supplemental reimbursement for each “qualifying evaluation or consultation code” to help dentists provide care to patients during the COVID-19 pandemic. Dentists are incurring dramatically increased costs and decreased patient volumes to comply with new infection control requirements.
Participating network providers received a letter from Delta Dental explaining the new Return to Care Supplemental Reimbursement Program, which will apply to service dates between June 22 and Oct. 20. Delta Dental indicated it will add the $10 reimbursement during claim processing.
The Delta Dental letter cites the following qualifying evaluation and consultation codes:
- D0120
- D0140
- D0145
- D0150
- D0160
- D0170
- D0180
- D0190
- D0191
- D8660
- D9310
- D9430
Included with the letter are FAQ about the program terms, including the application of frequency limitations and more. The letter expressly asks that providers not submit code D1999 to receive the temporary supplemental reimbursement.
Dental plans should provide reasonable economic relief to network providers
CDA earlier this month launched a grassroots campaign encouraging California dentists to contact dental plans to stress the need for stabilization grants to help sustain practices in the new COVID-19 environment.
Additionally, CDA continues to advocate for dental plans operating within the state to provide some form of reasonable economic relief to their provider networks to address the increased cost of care and ensure network adequacy for dental plan enrollees. These efforts include pursuing a legislative solution that would require plans to provide stabilization grants to contracted dental providers and to contribute to the cost of personal protective equipment through the end of 2021.
Most dental practices can expect to absorb an additional cost of $25 to $50 per patient, depending on the procedure. Dental practices are also reducing their typical patient volume for the mid- to long term to comply with the state’s social distancing directives and to maintain the highest level of safety for staff and patients in their offices.
While the temporary $10 reimbursement is a step in the right direction, CDA recognizes that it does not fully compensate dentists for the actual costs of PPE per patient and remains concerned that Delta Dental of California is not providing the partial compensation for a longer time frame that better fits realistic projections of PPE needs through the COVID-19 crisis.
Dental providers can read more about the Return to Care supplemental reimbursement program in the June 19 Delta Dental FYI newsletter. DeltaCare USA, PPO or Premier dentists are encouraged to email any questions to providerconcierge@delta.org.
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June 25, 2020 at 06:34AM
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Delta Dental of California temporarily offering supplemental reimbursement to network providers - CDA (California Dental Association)
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