Payment for Oral Health Services

Oral healthcare is a vitally important part of primary care and payment is a necessary part of offering oral health services within the medical setting.  Use these resources for help with getting paid for oral health services.

Medicaid Payment of Preventive Oral Health Services

Download this excel document to review Medicaid reimbursement rates, codes, age limits, and training required for preventive oral health services within the medical setting in each state. 

Private Payer Advocacy

If you are having trouble receiving payment for fluoride varnish application from a private payer, this template letter can be downloaded on your own letterhead. This letter can help help appeal denials for coverage and payment for topical fluoride varnish application by pediatricians.

Oral Health Coding Fact Sheet

View the current procedural terminology (CPT) and Dental Procedures and Nomenclature (CDT) codes to bill in this helpful reference document.

Video Series: Billing for Oral Health Services

Want to learn more about how to get paid for preventative oral health services? Register for this free online video course, Preventive Oral Health Services Video Series.

Video 1: Providing Fluoride Varnish in the Medical Setting (30 minutes)

Upon completion, you will be able to:

• Explain the benefits of integrating oral health care into clinical pediatric care and community-health promotion, as well as incorporating medical consultation into dental care.
• Build an oral health promotion program in your office including staff training, supplies, billing for services, and dental referrals.
• Code for oral health preventive services.

Video 2: Providing Preventive Oral Health Services in Practice (30 minutes)

Upon completion, you will be able to:

• Discuss dental caries and its consequences.
• Describe the causal pathways to caries and how to divert its course.
• Conduct caries risk assessment, anticipatory guidance, and counsel on caries prevention through good nutrition and oral hygiene.
• Explain new fluoride treatments and methods for applying fluoride varnish on children’s teeth.
• Offer collaborative relationships with your dental community.