COVID-19 Coding and Billing Interim Guidance : PPE
• This reimbursement will be paid monthly ' outside ' of the normal claim payment processes and will be based on claims with a date of service in May and June . Separate payment will be issued in June and July of 2020 for the prior month ’ s patient encounters .
• DCPG prefers that D1999 not be used for PPE . Payments will be made without the use of this code .
Florida Combined Life ( Florida Blue )/ Arkansas BlueCross BlueShield Dental / HMSA Dental ( Hawaii Blue Cross )
• Authorizing participating dental providers to bill charges for personal protective equipment ( PPE ) using CDT code D1999 , per visit per member for dates of service occurring 5 / 1 / 2020 through 12 / 31 / 2020 .
• Orthodontists will need to file a claim for member visits to receive reimbursement ; this will not be included with your monthly schedule payments .
• A maximum allowable charge will be added to the fee schedules . This compensation will be in accordance with the appropriate fee schedule and will not apply to the member ’ s annual maximum .
• A maximum allowable charge will apply , and balance billing is not permitted .
BCBS Kansas
• To help offset these additional PPE costs , BCBSKS will provide an add-on increase to all dental allowances starting with dates of service May 15 , 2020 for the remainder of the year .
• This special add-on increase does not require any action on the dentist ' s part , nor does it require any special CDT code billing .
• As such , we will continue to deny D1999 when billed as content of service . BCBSKS will automatically include an add-on allowance to every covered service that our local network dentists ’ bill .
• The new add-on allowances are figured based on a percentage of the maximum allowable payment ( MAP ) for services . Please note there will be a reduction beginning September 1 based on the anticipation that supply and demand of PPE will eventually level out and prices will come down .
• General Dentistry , Pedodontics , Periodontics : 3.0 % ( May 15-Aug . 31 ); 2.25 % ( Sept . 1-Dec . 31 )
• Oral / Maxillofacial Surgery , Orthodontics , Endodontics : 2.0 % ( May 15-Aug . 31 ); 1 % ( Sept . 1-Dec . 31 )
Delta Dental Insurance Company ( DDIC )
• Alabama , California , Delaware , Florida , Georgia , Louisiana , Maryland , Mississippi , Montana , Nevada , New York , Pennsylvania , Texas , Utah , Washington , D . C ., West Virginia
• For services beginning June 22 , 2020 through October 20 , 2020 , DDIC will offer a $ 10 “ Return to Care ” as supplemental reimbursement for network providers . [ Prior dates of service are not eligible ].
• Covered networks include DeltaCare USA , Delta Dental PPO , Delta Dental Premier , Delta Dental Federal ( Legion )
© 2020 American Dental Association All rights reserved . Last Reviewed : July 7 , 2020 9