Table of Contents
Introduction
A patient calls about tooth pain on a Friday afternoon. Instead of squeezing in an emergency slot or telling them to wait until Monday, the front desk sets up a quick video call with the dentist. That's teledentistry in its most common form — and it's become routine enough that most practices now run into it without ever deciding to "adopt telehealth" as a strategy.
The clinical side is usually the easy part. The billing side is where things get messy: which code represents a virtual visit, whether it's dental or medical coding, and whether the payer covers it at all. This guide covers what teledentistry actually is, how it works day to day, and the specific CDT codes involved — along with the documentation habits that keep those claims from bouncing back.
Key Takeaways
Remote Delivery
Teledentistry is dental care delivered remotely, either live (synchronous) or through stored data reviewed later (asynchronous).
ADA CDT Codes
Two ADA CDT codes cover it specifically: D9995 (synchronous) and D9996 (asynchronous).
Code Pairing
Neither code stands alone — both are reported alongside the actual procedure or evaluation performed.
Payer Variance
Coverage and documentation requirements vary by payer, plan, and state — there's no universal rule.
Place of Service
Place of service 02 (telehealth) belongs on the claim alongside the CDT code.
What Is Teledentistry?
Teledentistry is the delivery of dental care, consultation, or education using audio, video, or stored clinical data instead of an in-person visit. It comes in two forms:
- Synchronous teledentistry is a live, real-time interaction — typically video — between the patient (or an on-site caregiver) and the dentist.
- Asynchronous teledentistry, often called "store-and-forward," involves collecting data like photos, radiographs, or charting at one point in time and sending it to a dentist for review later, with no live interaction involved.
It's used for triage, post-operative follow-up, oral health education, second opinions, and specialist collaboration — not as a replacement for procedures that require hands-on treatment.
How Does Teledentistry Work?
Most billing problems trace back to the documentation and coding steps — not the clinical encounter itself.
Benefits of Teledentistry
- ▶ For patients: Less travel, faster access for urgent concerns, easier follow-up after treatment, and better access for patients in rural areas or with mobility limitations.
- ▶ For dentists: A practical triage tool, a way to handle quick consultations without filling a chair, and a channel for clearer pre- and post-treatment communication.
- ▶ For practices: Better schedule flexibility, potential for improved patient engagement, and — when billed correctly — an additional, legitimate revenue stream rather than unbilled phone advice.
Teledentistry Services That May Be Delivered Remotely
| Use Case | How It Works | Billing Consideration |
|---|---|---|
| New patient triage | Patient shares symptoms/photos; dentist assesses urgency remotely | May support a limited exam code plus a teledentistry code |
| Post-op follow-up | Live or asynchronous check-in after a procedure | Coverage for follow-up-only visits varies by payer |
| Second opinion / specialist input | Images or video shared with a specialist for consultation | Documentation should show who reviewed what, and when |
| Oral health education | Live or recorded guidance on hygiene or post-treatment care | Some payers require this be tied to a billable evaluation |
| Screening/assessment | Photos or video used for a preliminary evaluation | Not a substitute for an in-person exam where one is required |
Not every procedure can be performed remotely, and coverage always depends on the payer and applicable state rules.
Teledentistry Billing Codes
The ADA introduced two CDT codes specifically for teledentistry, and they remain the primary codes dental practices use for these encounters:
| Code | What It Represents | Code Set | Notes |
|---|---|---|---|
| D9995 | Teledentistry, synchronous — real-time audio-video encounter | CDT (ADA) | Reported alongside the primary procedure code, not alone |
| D9996 | Teledentistry, asynchronous — store-and-forward review | CDT (ADA) | Used when data is reviewed later, with no live interaction |
| POS 02 | Place of service: telehealth | ADA/CMS claim form field | Enter on the claim alongside the CDT code(s) |
Both D9995 and D9996 are reported in addition to the actual procedure performed — typically an evaluation or consultation code — not as a standalone line item. Medical-dental crossover cases, such as a hospital-based dental encounter billed under medical coverage, follow separate CPT/HCPCS telehealth rules that change independently of CDT policy; verify those directly with CMS or the applicable medical payer rather than assuming dental telehealth rules carry over.
CDT vs. CPT for Teledentistry
The presence of a telehealth encounter doesn't by itself determine which code set applies — that depends on which payer and plan is billed.
| CDT | CPT/HCPCS |
|---|---|
| Dental procedure coding, submitted on an ADA claim form | Medical procedure coding, submitted on a medical claim form |
| Coverage depends on the dental plan and CDT-specific policy | Coverage depends on the medical payer's telehealth policy |
| D9995/D9996 apply specifically to teledentistry encounters | Medical telehealth E/M rules differ and change frequently |
| Used for most routine and specialty dental teledentistry | Relevant mainly for medical-dental crossover billing scenarios |
Documentation Checklist
Exact requirements vary by payer and state — this is a general documentation framework, not a guaranteed payer checklist.
Common Teledentistry Billing Mistakes
| Common Mistake | Why It Causes Problems | Better Approach |
|---|---|---|
| Assuming every payer covers teledentistry the same way | Coverage varies widely by plan and state | Verify the specific plan's teledentistry policy before the visit |
| Billing D9995/D9996 alone, with no primary procedure code | These codes represent the delivery method, not a standalone service | Always pair with the actual exam/consultation code performed |
| Missing place-of-service 02 | Claims can be rejected or flagged without it | Confirm POS is entered correctly on every teledentistry claim |
| Thin documentation of the encounter | Payers may deny for insufficient support | Document modality, time, findings, and recommendations clearly |
| Confusing dental and medical coding for crossover cases | CDT and CPT/HCPCS follow different rules | Route medical-dental crossover claims through the correct payer and code set |
Why Teledentistry Claims Get Denied
Denial risk generally clusters around a few areas: eligibility (low-to-medium risk if verified upfront), coding and modifier accuracy (medium risk, since D9995/D9996 usage is still inconsistent across practices), documentation completeness (medium-to-high risk, especially for asynchronous encounters), and payer-policy mismatches (high risk, since telehealth coverage rules vary the most from payer to payer). Timely filing applies the same way it would to any other claim.
Improving Teledentistry Revenue Cycle Management
- ▶ Verify eligibility and teledentistry-specific coverage before the encounter, not after
- ▶ Standardize documentation templates for both synchronous and asynchronous visits
- ▶ Review coding accuracy regularly, specifically for D9995/D9996 pairing with primary codes
- ▶ Scrub claims for place-of-service and code-pairing errors before submission
- ▶ Track denials by payer and root cause instead of resubmitting without investigating
- ▶ Periodically audit teledentistry billing as policies continue to evolve
Why Dental Billing Support Matters
Sirius Solutions Global works as an AI-assisted, human-verified medical and dental billing and RCM provider, supporting practices across specialties including dental billing. Our team helps practices with eligibility verification, coding and revenue audits, claims submission, denial management, and A/R follow-up — the same workflow pieces that determine whether a teledentistry claim gets paid cleanly or sits in appeals.
Teledentistry doesn't need to be a billing headache. Getting the coding, documentation, and payer verification right up front is what keeps it from becoming one.
Frequently Asked Questions
Disclaimer: This article is for general informational purposes and does not constitute legal, compliance, coding, or reimbursement advice. Teledentistry coverage, billing codes, and documentation requirements can vary by payer, plan, state, and year. Always verify current CDT, CMS, and payer-specific guidance before submitting a claim. CDT is a registered trademark of the American Dental Association.