One thing that stays constant is change – and there is no exception to this rule regarding CDT codes.  

Code revisions take place based on the best interests of the profession, patients, and payers and will have a varied impact based on their relevance and code usage for each dentist. 

For 2025, the updates include:

• 10 new codes
• 8 revised codes
• 2 deleted codes

Remember that a new or revised code does not dictate reimbursement from insurance providers.

Recognized codes may not be reimbursed at all.  Consider it a language that providers and insurance companies understand; it helps communicate the services provided numerically.

• Updating your system annually with code revisions:
• Helps clarify treatment for team members, patients, and third-party payers
• Provides accurate estimates for your patient base
• Enables proper reimbursement from third-party payers

Most carriers notify in-network providers of their requirements and reimbursement protocols before the end of the year.  We encourage you to follow a three-part protocol annually:

1. Contact insurance companies you are contracted with to review processing guidelines for upcoming changes.
2. Facilitate a team meeting where you discuss CDT changes and how their impact may shift chart note records, posting, and patient communication for your offered procedures.
3. Set fees for new codes and remove deleted codes from your billing software.

While we don’t expect a change in fees for revised codes, finding average fees for new codes is difficult. The National Data Advisory Service (NDAS) and Fair Health Consumer calculate fee averages based on filed insurance claims over time. It takes 6 months to a year to see averages for new codes. When setting fees for new codes, consider referencing your carrier fee schedules. If they list reimbursement rates for the new codes, consider a 30-50% increase to the fee listed, as PPO contracts typically require a 30-50% write-off. For the rest of the codes, we recommend setting a fee based on the following:

• Cost of material/lab fees
• Cost to turn over an operatory (2023 average was $11.88)
• Hourly compensation for clinician(s) needed
• 40-50% additional for profit margin

10 New Codes
D2956	Removal of an indirect restoration on a natural tooth
D6180	Implant maintenance procedures when a full arch fixed hybrid prosthesis is not removed, including cleansing of prosthesis and abutments
D6193	Placement of an implant screw
D7252	Partial extraction for immediate implant placement
D7259	Nerve dissection
D8091	Comprehensive orthodontic treatment with orthognathic surgery
D8671	Periodic orthodontic treatment visit associated with orthognathic surgery
D9913	Administration of neuromodulators
D9914	Administration of dermal fillers
D9959	Unspecified apnea services procedure, by report

 

8 Revised Codes
D0160	Detailed and extensive oral evaluation – problem focused by report. Includes sleep-related breathing disorders.
D0801	3D intraoral surface scan – direct. Includes any aspect of intraoral anatomy.
D1330	Oral hygiene instructions. Examples were removed from definition.
D2940	Placement of interim direct restoration, now includes manage caries, create a seal for endodontic isolation until definitive treatment can be rendered.
D6011	Surgical access to an implant body (2nd stage implant surgery).
D6080	Implant maintenance procedures when a full arch fixed hybrid prosthesis is removed and reinserted, including cleansing of prosthesis and abutments
D6081	Scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing, and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure.
D6090	Repair of implant/abutment supported prosthesis.

 

2 Deleted Codes
D2941	Interim therapeutic restoration – primary dentition
D6095	Repair implant abutment – by report

Reach out to your Burkhart Account Manager or Burkhart’s Practice Support Team with your questions regarding changes in codes, coding strategies to maximize reimbursement, and analyzing managed care participation in your practice.

 

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Your success is our success. Please reach out to us anytime.
Learn more, visit the Practice Support Team page, email us at PracticeSupportTeam@BurkhartDental.com, or call 1.800.665.5323.

Category: Practice Consulting

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